This dataset includes the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI) Standardized Infection Ratios (SIR) adjusted for patient care locations for hospitals, long-term acute care and patient care areas.
• Acute Care Hospitals: Critical access acute care hospital (CAH; defined as certain facilities that participate in Medicare and that are designated by states through a protocol)
• Long-term Acute Care Hospitals (LTACs) are defined by the Centers for Medicare and Medicaid Services as providing care to patients with medically complex conditions requiring an average length of stay greater than 25 days.
• Four Patient Care Areas include: 1) Critical Care Areas (CCAs) are nursing care areas that provide intensive observation, diagnosis, and therapeutic procedures for patients who are critically ill. These areas exclude step-down, intermediate, or telemetry care areas. 2) Neonatal Critical Care (NCC) Areas specialize in Level II/III and/or Level III critical care provided to newborns and infants. 3) General Care Areas (WARDS) include the following types of locations: stepdown general care locations specializing in patients that are hemodynamically stable; medical general care locations providing evaluation and treatment of nonsurgical conditions; medical/surgical general care locations providing evaluation and treatment of medical and/or surgical conditions; surgical general care locations providing evaluation and treatment for pre- or post-surgical conditions; long-term acute care locations specializing in patients requiring an extended stay in an acute care environment; adult rehabilitation general care locations providing care to patients who have lost function; labor, delivery, recovery, postpartum general care locations providing evaluation and treatment of normal and high risk pregnancy patients; behavioral general care locations providing evaluation and treatment of patients with acute psychiatric or behavioral disorders; jail general care locations providing evaluation and treatment of patients who are in custody of law enforcement during their treatment; pediatric general care locations providing evaluation or treatment to any patient less than or equal to 18 years of age for any medical or surgical condition; and pediatric rehabilitation locations providing care to patients less than or equal to 18 years of age who have lost function. 4) Special Care Areas (SCA) are nursing care areas which specialize in patients who undergo bone marrow (stem cell) transplant for the treatment of various disorders; or require management and treatment for cancer and/or blood disorders; or require postoperative care after solid organ transplant.
Acute Care Hospital and LTAC Methods: The CLABSI data for each hospital include number of observed (reported) CLABSIs, number of predicted CLABSIs (based on the national baseline data), number of central line-days, CLABSI SIRs and their associated 95% confidence intervals, and the statistical interpretation as follows:
• No difference - no difference in number of observed and predicted infections
• Higher - more infections than predicted, or
• Lower - fewer infections than predicted.
CLABSI SIRs are influenced by clinical and infection control practices related to central line insertion and infection control maintenance practices, patient-based risk factors, and surveillance methods. While CLABSI SIRs are only adjusted for patient care locations, they cannot control for all individual patient factors that can affect CLABSI SIRs. A low CLABSI SIR may reflect greater diligence with infection prevention or may result from less effective surveillance methods that detect fewer infections, including failure to appropriately apply standardized surveillance definitions and protocols. Similarly, a high SIR may reflect failure to consistently implement all recommended infection prevention practices or more aggressive infection surveillance including more consistent application of standardized surveillance definitions and protocols. Finally, SIRs cannot be compared across hospitals because of the limitation in the "indirect" standardization methodology used in calculating the SIRs.
Patient Care Area Methods: These combined CLABSI rates table shows the hospital-specific CLABSI data and central line insertion practices (CLIP) adherence percent by patient care locations in CCAs, NCCs and one treatment area within SCA, "Oncology - Medical/Surgical Critical Care", Permanent and Temporary Central Line Days. The CLABSI measures include the number of CLABSIs, central line-days, patient days, CLABSI rates and their 95% confidence intervals. We also performed statistical analyses to determine if the rates are statistically higher, lower, or no different than the California average rates by patient care locations. We know CLABSI rates are influenced by clinical and infection control practices related to central line insertion and maintenance procedures, patient-based risk factors, and surveillance methods. While stratifying CLABSI rates by patient care location makes rates more comparable, this data risk adjusted procedure cannot control for all individual patient factors that can affect CLABSI rates. A low CLABSI rate may reflect greater diligence with infection prevention or may result from less effective surveillance methods that detect fewer infections, including the failure to consistently apply all currently accepted standardized surveillance definitions and protocols. Similarly, a high rate may reflect the failure to consistently implement all recommended infection prevention practices or use more aggressive infection surveillance methods that can include the application of standardized surveillance definitions and protocols.
To link the CDPH facility IDs with those from other Departments, like OSHPD, please reference the "Licensed Facility Cross-Walk" Open Data table at https://data.chhs.ca.gov/dataset/licensed-facility-crosswalk.
Health and Safety Code section 1288.55(a)(1) requires general acute care hospitals to report to the California Department of Public Health (CDPH) all cases of MRSA BSI identified in their facilities. The data are submitted by California hospitals to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN). For more information on data collection processes and methods, please see the "MRSA and VRE BSI Technical Notes" of the healthcare-associated infections (HAI) report on: https://www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/HAIProgramHome.aspx.
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