Background: In September 2012, CDC released the National Healthcare Safety Network (NHSN) Long-term care facility (LTCF) Component, a surveillance system for reporting urinary tract infections (UTI) and laboratory identified multidrug-resistant organisms (MDRO) including C. difficile infection (CDI). To evaluate early use of the LTCF Component, we explore characteristics of LTCFs enrolled and reporting patterns for select events.
Methods: We performed descriptive analysis of characteristics from the NHSN annual facility survey by LTCF type; nursing homes (NH), chronic care facilities (CCF), and assisted living facilities (ALF) enrolled between January 2013 and December 2014. Data from monthly reporting plans were used to characterize each LTCF intent to report UTI or MDRO, and compared with completed monthly data (both numerator and denominator data reported). Trends in LTCF reporting were analyzed overall and by year; consistent reporting defined as ≥6 months of completed data in a calendar year.
Results: During the first two years, 200 LTCFs enrolled into NHSN: 198 NH, 1 CCF and 1 ALF. LTCF were independent (35.5%), part of a hospital system (33.5%), or part of a multi-facility organization (28%). The median number of facility beds was 110 (IQR 69-159). The median number of staff hours/week dedicated to infection control was 14 (IQR 8-24) and increased with higher facility bed number. The geographic distribution of enrolled LTCFs identified certain states with higher LTCF use of NHSN (Figure 1). Over the 2 year period, 156 NHs submitted 1640 monthly event reporting plans. CDI events were most often selected (83% of plans); UTI had the most completed months (546/667 mo.). While the mean consecutive months of reporting was similar between each year (5.8 mo. vs. 4.7 mo.), consistent reporting was higher in 2013 compared with 2014 (65% vs. 37.8%, Chi-square, p <0.01).
Conclusion: Under voluntary use, 198 NHs enrolled in the NHSN LTCF Component, 1.3% of all U.S. NHs. Clustering of enrolled LTCFs by state reflect education and outreach performed by state health departments, highlighting their role in driving early LTCF NHSN use. Exploring the decrease in consistent reporting in 2014 reporting is necessary to identify barriers to sustained reporting.
Figure 1. Long-term care facility enrollment in the National Healthcare Safety Network by state, 2013&2014
N. D. Stone,
D. Nguyen, None
A. Anttila, None
N. D. Thompson, None