HAI Reporting and Epidemiology

Topics on the webpage:

HAI Reporting Requirements l HAI Reports and Dashboards l HAI Outbreak Investigation l NHSN Hospital User Group l NHSN Long Term Care Facilities User Group l Contact Us

HAI Reporting Requirements

The Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Program monitors and validates data on reportable HAIs from Washington hospitals. Washington State updated WAC 246-440-100 Hospital reporting requirements for healthcare-associated infections effective January 2020 to include five reportable HAIs. For more information on these conditions, click on the linked HAIs below to view the CDC’s webpage for that infection.

The graphic below shows the five reportable HAIs by location.

Catheter-associated Urinary Tract Infection (CAUTI) is represented by a urinary catheter, with an indicator to the location of the urinary tract.
Central Line-associated Bloodstream Infection (CLABSI) is represented by an IV stand with an indicator to the location of a vein where a central line would be placed.
Clostridioides difficile (C. difficile) infection with positive laboratory identification is represented by bacteria with an indicator to the location of the intestines.
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with positive laboratory identification is represented by bacteria, with an indicator to the location of major artery.
Surgical Site Infection (SSI) is reportable following an Abdominal Hysterectomy (SSI-HYST) or Colon Surgery (SSI-COLO). SSI-HYST is represented by a surgical incision with an indicator to the location of the uterus. SSI-COLO is represented by a surgical incision with an indictor to the location of the colon.

Silouette showing body locations for 5 reportable HAIs. — **Image of the human body, noting the five reportable HAIs by location**

Washington State Requirements

Hospitals licensed by the Washington State Department of Health are required to report information about certain HAIs using the National Healthcare Safety Network (NHSN) system.

The HAI Epidemiology team monitors reported HAIs, provides technical support to facilities on the use of NHSN, and partners with healthcare facilities to reduce preventable infections associated with healthcare.

For detailed information regarding Washington State reporting requirements:

Some Multi-Drug Resistant Organisms (MDROs) and all suspected or confirmed healthcare outbreaks are reportable as notifiable conditions, separate from WAC 246-440-100. For additional information on MDRO reporting, please see the List of Notifiable Conditions

HAI Reports and Dashboards

HAI Dashboards

HAI Dashboards are currently available for device-associated HAIs, laboratory-identified (LabID) HAIs, and surgical site infections (SSIs). The dashboards show annual data on HAIs that hospitals have to report. The dashboards display the last 5 years of available data.

The Device-Associated HAI Dashboard includes data for CLABSI and CAUTI.
The LabID Dashboard contains data for CDI and MRSA bacteremia.
The SSI Dashboard includes data for SSI-COLO and SSI-HYST.

More information about the dashboards can be found on Washington Tracking Network’s HAI page.

Device-Associated HAI Dashboard

Statewide data table and graph showing CAUTI or CLABSI trends over time. — **Screen capture of the Statewide Summary Trends tab of the device-associated dashboard, showing annual Washington state SIRs over time**

Laboratory-Identified HAI Dashboard

For more information on testing criteria, risk factors, and the algorithm for CDI testing, see the Clostridioides Difficile Testing Guidance (PDF).

Surgical Site Infection Dashboard

Annual HAI Reports

Under RCW 43.70.056, WA DOH is charged with using data submitted to the National Healthcare Safety Network (NHSN) to compile and publish reports. This report provides comprehensive and detailed information on Washington hospital performance.

The CDC also publishes annual reports using data reported to NHSN’s Patient Safety Component, which presents national and state-level HAI Standardized Infection Ratios (SIRs) and Standardized Utilization Ratios (SURs). To view the CDC’s Annual Reports, visit their webpage for HAI Progress Reports.

HAI Validation

Hospitals licensed by the WA DOH are required to report information about certain HAIs using NHSN. Washington State law (RCW 43.70.056) requires that WA DOH regularly evaluate the quality and accuracy of required HAI reporting. To do so, the HAI & AR Program follows validation guidance from the Centers for Disease Control and Prevention. This report provides detailed information on WA DOH’s annual validation efforts.

Healthcare Outbreak Investigation

The HAI Epi Team participates in healthcare associated investigations and outbreaks with local health jurisdictions. Outbreaks are investigated in all health care settings, with a particular focus on long-term care as a vulnerable population.

The HAI Epi Team also participates in investigations related to bloodborne pathogen exposures, high level disinfection breaches, and suspect drug diversions.

To contact the HAI Epi Outbreak Investigation Team, email HAIEpiOutbreakTeam@doh.wa.gov.

NHSN Hospital User Group Call

The HAI Epi Team hosts a quarterly informational meeting for hospital staff to discuss changes in NHSN reporting, review analysis of User Group data, and address any questions from NHSN users. This call takes place the second Tuesday of January, May, July, September, and November from 10:30am to 11:30am.

This call is open to all hospital staff who use NHSN. If you are interested in attending the Quarterly NHSN User Group call, email the HAI Epi Team at HAI@doh.wa.gov and include “NHSN Hospital User Group” in the subject line.

NHSN Long Term Care Facilities User Group Call

The LTC NHSN HAI Epi Team also hosts monthly information meeting to provide NHSN updates, foster collaboration, and increase user knowledge. This call takes place the second Thursday of every month from 11am to 12pm.

The LTC NHSN User Group Call is open to all LTCF staff who use NHSN. If you are interested in attending the Monthly NHSN LTC User Group, register at this Zoom webinar link. Email HAI-COVID@doh.wa.gov with any questions.

For a more comprehensive list of all NHSN support options the HAI Epi Team can provide, see the NHSN Support and Technical Assistance for Skilled Nursing Facilities (PDF)