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Healthcare-Associated Infections (HAI) Standardized Infection Ratio (SIR) Data

Contact: Florida Health


Use of National Healthcare Safety Network (NHSN) Tracking System to prevent Health Care-Associated Infections (HAI) in Florida

The State of Florida is now able to track the HAI reported by acute-care hospitals (ACH), critical-access hospitals (CAH), inpatient rehabilitation facilities (IRF), and long-term acute-care hospitals (LTACH) using the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN) infection tracking system reported by facilities on select HAI:

The surveillance data from this system is used to direct actions to identify areas of infection control that need improvement and measure progress of prevention efforts toward reducing HAI through the process of conducting Infection Control Assessment and Response (ICAR) and Targeted Assessment and Prevention (TAP) strategy. The key measure that is used to track HAI is the Standardized Infection Ratio (SIR).

What is the Standardized Infection Ratio?

SIR is a risk-adjusted summary measure, a ratio that shows both direction and magnitude. It compares a health care facility’s observed number of infections to the predicted number of infections based on 2015 national aggregate data. Under the new 2015 re-baseline model, the risk-adjusted measure SIR, specifically predicting infections for each facility, is computed using the data that a health care facility submits each year in an annual survey. The number predicted is risk adjusted to account for differences in health care facilities and allow for a measurable comparison.

HAI Trend: 2015 – 2018 (January – September)

This chart shows the yearly comparison and trend over time for the healthcare associated infection metrics – Central line – Associated Bloodstream Infections, Catheter- Associated Urinary Tract Infections, Ventilator Associated Events, Surgical Site Infections for Colon Surgery and Abdominal Hysterectomy and Multi Drug Resistant Organisms – Methicillin Resistant Staphylococcus Aureus and Clostridium Difficile Infections for the state of FL. The HAI metrics are listed on the x axis, and Standardized Infection Ratio or SIR on the left-hand Y axis. The 2015 National Baseline is 1. There has been a reduction in SIR’s for CLABSI, CAUTI, VAE, CDI & SSI- Abdominal Hysterectomy since 2015. A slight increase in trend was observed for SSI – Colon Surgery in 2018 (Jan – September). The SIR values for these HAIs are less than 1. However, the SIR values for MRSA has been greater than 1 since 2015 and the current SIR value for 2018 (Jan- September) is 1.05.

2020 HHS SIR Goals

The U.S. Department of Health and Human Services (HHS) proposed new targets for the national acute-care hospital metrics for the National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination (HAI Action Plan) in October 2016.

HAI Metric2020 Reduction Target
(From 2015 Baseline)
2020 HHS SIR Goal
CLABSI50%0.50
CAUTI25%0.75
CDI30%0.70
MRSA50%0.50
SSI - Ab. Hys30%0.70
SSI - Colon30%0.70

State’s HAI Progress in achieving the proposed HHS SIR Goal:

Comparison of State SIR to HHS SIR Goal for Acute-Care Hospitals in Florida

HAI Metric2018 ( January - September )2020 HHS SIR GoalTarget Met?
CLABSI0.750.50
CAUTI0.730.75
CDI0.620.70
MRSA1.050.50
SSI - Ab. Hys0.860.70
SSI - Colon0.820.70

How does the State compare to 2016 National SIR?

This chart compares the 2018 (January – September) FL HAI value for each metric Central line – Associated Bloodstream Infections, Catheter- Associated Urinary Tract Infections, Ventilator Associated Events, Surgical Site Infections for Colon Surgery and Abdominal Hysterectomy and Multi Drug Resistant Organisms – Methicillin Resistant Staphylococcus Aureus and Clostridium Difficile Infections to the 2016 National SIR. The Standardized Infection Ratio or SIR is listed on the x axis and the HAI metrics are listed on the Y-axis. The state’s HAI SIR values are below the 2016 National SIR values for all metrics, except MRSA. The 2016 National SIR value for MRSA is 0.94, while the State’s MRSA SIR value is 1.05. A dotted line has been placed at 1, to also indicate that the SIR value for MRSA is above 2015 National Baseline.

Note: Above data is a representation of those acute care facilities reporting to meet Centers for Medicare & Medicaid Services’ (CMS) Inpatient Quality Reporting (IQR) program for reportable HAI types. 2017 and 2018 ( January – September ) FL SIR does not include data of the U.S. Department of Veterans Affairs (VA)/ Military Hospitals (10 facilities) that the state does not have access to under the Data Use Agreement (DUA).

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