The Florida Department of Health has established a data use agreement with the CDC’s National Healthcare Safety Network, a national health care-associated infection (HAI) surveillance system. Data entered into NHSN and accessed by DOH is protected and confidential and shared in aggregate. DOH epidemiologists assure the data quality, send feedback reports, and provide technical support to facilities on the use of NHSN.

Florida does not have any HAI reporting requirements, but acute care hospitals, outpatient hemodialysis facilities, long-term acute care hospitals, and inpatient rehabilitation facilities participating in quality improvement programs with the U.S. Centers for Medicare and Medicaid Services (CMS) are required to report HAI data in NHSN. HAI data are reported to CMS quarterly to align with CMS reporting requirements.

Annual reports describe a summary of select HAIs across acute care hospitals providing state-level data about HAI incidence throughout the year. DOH monitors these reports and offers consultation and assistance to facilities with higher-than-expected infection rates. For more information on these consultations, contact HAI_Program@FLHealth.gov.

Annual Reports

All data presented are provisional and subject to change.

2022 Annual HAI Report (Data Source: HAI Progress Report)

2021 Annual HAI Report (Data source: HAI Progress Report)

NHSN Resources

SurveiLlance Tools

Surveillance tools for enrolled facilities – Select your health care setting type to access NHSN protocols and resources specific to that setting.

Protocols

NHSN Metrics

Health care facilities collect and report data on health care-associated infections to NHSN using standardized definitions. HAI data are used for a variety of purposes, which may include, satisfying reporting mandates, comparing infection rates between and within health care facilities, providing consumers with information, guiding policies and procedures, evaluating the effectiveness of interventions, and conducting research.

Surveillance data can be categorized into process measures or outcome measures.

Process Measures

Measures adherence to recommended practices that may affect outcomes.

Process measures have a 100% target adherence rate and are a more direct measure of quality and outcome. These measures apply to a variety of health care settings and often reflect promotion of evidence-based best practices to improve patient outcomes or quality of care.

Examples: Hand hygiene compliance rate, adherence to cleaning catheter hubs and injection ports before access, percentage of environmental cleanings completed appropriately.

Outcome Measures

Measures actual results.

Outcome measures have variable goals and often require risk adjustment. These measures allow you to see whether changes are leading to improvement such as reducing and preventing HAIs. These measures may not be collected in all healthcare settings and may not involve direct care or provider accountability.

Example: CLABSI, CAUTI, and SSI SIRs

Standardized Infection Ratio (SIR)

Purpose: The primary summary measure used by NHSN to trackhealthcare-associated infections at a national, state, or facility level over time.

Calculation: number of observed infections / number of predictedinfections.

Interpretation:

  • If SIR > 1.0, more infections were observed than predicted.
  • If SIR > 1.0, less infections were observed than predicted.
  • If SIR = 1.0, the same number of infections were observed as predicted.

Standardized Utilization Ratio (SUR)

Purpose: A risk-adjusted measure used to compare device utilization at the national, state, or facility level by tracking central line, urinary catheter, and ventilator use.

Calculation: number of observed device days / number of predicted device days.

Interpretation:

  • If the SUR < 1.0, fewer device days were reported than predicted.
  • If the SUR = 1.0, the same number of device days were observed as predicted.
  • If the SUR > 1.0, more device days were observed than predicted.
  • The SUR is designed to be a high-level indicator of device use and should not be used to draw conclusions around whether devices are overused or underused.
  • The SUR should be used in conjunction with the SIR.

Cumulative Attributable Difference (CAD)

Purpose: A risk-adjusted measure that indicated the number of infections that must be prevented within a group, facility, or unit to achieve an HAI reduction goal

Calculation: (number of observed infections) — (number of predicted infections* SIR goal)

Interpretation:

  • A positive CAD is the number of excess infections a facility would have needed to prevent to achieve an HAI reduction goal during a specified time.
  • A negative CAD means the facility has reached or surpassed the HAI reduction goal.
  • Usually presented as a whole number.

Standard Antimicrobial Administration Ratio (SAAR)

Purpose: A standardized metric of antimicrobial use for specified patient care locations.

Calculation: number of observed antimicrobial days / number of predicted antimicrobial days.

Interpretation:

  • If the SAAR>1.0, more antimicrobial used was observed than predicted.
  • If the SAAR <1.0, less antimicrobial use was observed than predicted.
  • If the SAAR = 1.0, the same antimicrobial use was observed as predicted.
  • A SAAR is not a definitive measure of appropriateness or judiciousness of antimicrobial use, and any SAAR value may warrant additional investigation.