Data shown as of August 11, 2025.
This dashboard shows trends in Washington state for healthcare-associated infections (HAIs). An HAI is an infection that develops in a patient during, or soon after, they receive healthcare services or visit a health care setting. These settings can include:
- Hospitals
- Clinics
- Doctor’s offices
- Surgery centers
- Dialysis centers
- Nursing homes
- Home-care visits
HAIs are caused by bacteria, fungi, viruses, and other common pathogens that enter the body through susceptible body sites such as an open wound or an invasive medical device, such as a catheter. These infections can cause serious illness and death, but many are preventable.
This dashboard summarizes HAI data reported by acute care hospitals to the Centers for Medicare and Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), and the WA DOH through the National Healthcare Safety Network (NHSN).
The Revised Code of Washington (RCW) 43.70.056 requires us to release these data, which also requires hospitals to collect and submit HAI data to the WA DOH via CDC’s NHSN. Under the RCW, WA DOH is charged with using data to compile and publish reports, implement regional infection prevention strategies, and evaluate the quality and accuracy of HAI reporting. The Washington Administrative Code (WAC) 246-440-100 establishes the data collection and submission requirements of hospitals. It was updated in January 2022 to align with CMS reporting categories and criteria.
Data Downloads
Acute Care Hospital Information Data (Excel)
National data is available at Current HAI Progress Report, CDC.
Technical Notes
NHSN (Data Source and Limitations)
This report summarizes HAI data reported to the CMS, CDC, and the WA DOH through the National Healthcare Safety Network (NHSN). NHSN is a free and secure web-based data management system developed and maintained by CDC. The CDC and the WA DOH provide support to hospital surveillance staff on the appropriate use of the system and guidance to track infections using a standardized methodology. Learn more about the National Healthcare Safety Network, CDC.
Per WAC 246-440-100 Hospital reporting requirements for health care-associated infections and CMS, hospitals must report five types of HAIs into the CDC’s NHSN system:
- Catheter-associated urinary tract infection (CAUTI)
- Central line-associated bloodstream infection (CLABSI)
- Clostridioides difficile infection (CDI)
- Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia
- Surgical site infections following colon surgery (COLO)
- Surgical site infections following abdominal hysterectomies (HYST)
The WA DOH HAI/AR Program established a data use agreement (DUA) with the CDC. The DUA allows WA DOH to use NHSN to retrieve and report data submitted by hospitals. The Washington state data included in this report has been reported to CMS.
HAIs
CAUTI
An indwelling urinary catheter is a drainage tube that is inserted into the urinary bladder through the urethra. It is eft in place and connected to a closed collection system. A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidneys. A catheter-associated urinary tract infection (CAUTI) occurs when germs (usually bacteria) enter the urinary tract through the indwelling urinary catheter and causes an infection.
The CAUTI data in this report includes all data reported from adult and pediatric ICUs and adult and pediatric medical, surgical, or combined medical/surgical wards.
CLABSI
A Central Line-Associated Bloodstream Infection (CLABSI) occurs when bacteria enter a person’s bloodstream through a central line. A central line is a long, flexible tube (catheter) that is inserted into a large vein in the neck, chest, upper arm, or leg. It allows access to a patient’s bloodstream with a tip that ends near the heart. They are used to monitor pressure inside the heart, as access for laboratory, or to provide medicine, nutrients, and fluids. Central lines are typically kept in place longer than a regular intravenous (IV) catheter and are often used to treat kidney disease (dialysis) or cancer (chemotherapy). Patients can be discharged from the hospital with a central line in place if they require continuous treatment at home or an outpatient infusion facility.
The CLABSI data in this report includes all data reported from adult, pediatric, and neonatal ICUs and adult and pediatric medical, surgical, or combined medical/surgical wards.
CDI
Clostridioides difficile, also known as “C. difficile” or “C. diff,” is a bacterium (germ) that can cause severe diarrhea, colitis, sepsis, and death. Most cases of Clostridioides difficile infection (CDI) occur in people who are currently or have recently been taking antibiotics, clearing the way for C. diff to colonize the gastro-intestinal tract.
The CDI data in this report includes positive CDI tests from all inpatient and emergency locations in the hospital. Only CDI cases considered healthcare facility-onset are included; these are cases identified after the patient has been in the hospital for at least 4 days.
MRSA
Staphylococcus aureus (SA) are bacteria commonly found on the skin. Although these bacteria are generally harmless, they can cause infections ranging from pimples or boils to serious infections of internal organs. Most SA infections are minor and do not require treatment with antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of SA that has become resistant to certain antibiotics. MRSA bacteremia occurs when Methicillin-resistant Staphylococcus aureus is in a patient’s bloodstream. It is a more severe form of SA infection.
The MRSA data in this report includes positive laboratory results of MRSA in the bloodstream from patients in any inpatient or emergency location of the hospital. Only MRSA bacteremia cases that are identified in patients who have been in the hospital for at least 4 days are included.
COLO
A surgical site infection (SSI) is an infection that occurs after surgery is performed. These infections can spread on surface (superficial) skin layers, cuts that are deeper in the muscle and connective tissues (deep incisional), and organs or cavities between organs (organ space).
Colon (large intestine or bowel) surgeries involve a surgical incision made to access the intestinal cavity to repair or remove part of the large intestine. Some colon repairs include removing diseased or damaged colon (resection), attaching healthy parts of the colon together (anastomosis), or making an opening in the colon to remove waste (ostomy).
A SSI following a colon surgery (COLO) can affect the tissue around the incision and cause a superficial infection in skin and tissue. It can also cause a deep infection in the muscles, connective tissues, organs like the gastrointestinal tract, or the intra-abdominal area.
The COLO data included in this report includes only events that were reported to CMS. This includes SSIs identified within 30 days of surgery, in patients who were 18 years or older at the time of the surgery and had one or more overnight stay in the hospital. Superficial SSI, which are limited to the skin and subcutaneous tissue layers, are excluded. SSIs with documentation in the surgical report of visible signs of infection during surgery are also excluded.
HYST
A surgical site infection (SSI) is an infection that occurs after surgery is performed. These infections can spread on surface (superficial) skin layers, cuts that are deeper in the muscle and connective tissues (deep incisional), and organs or cavities between organs (organ space).
Abdominal hysterectomy (HYST) is a common surgical procedure in which the uterus is removed through an incision in the lower abdomen. Common infections affect the area around the incision. This is a superficial infection, as the area affected is limited to the skin and subcutaneous tissue. Other more serious SSIs can result in a deep infection in the muscles or an infection affecting the reproductive tract in the area around the abdomen.
The HYST data included in this report includes only events that were reported to CMS, which include SSIs identified within 30 days of surgery, in patients who were 18 years or older at the time of the surgery and had one or more overnight stay in the hospital. Superficial SSIs, which are limited to the skin and subcutaneous tissue layers, are excluded. SSIs with documentation in the surgery report of visible signs of infection during surgery are also excluded.
Standardized Infection Ratio
Explanation
The Standardized Infection Ratio (SIR) helps track HAIs over time and can be calculated for different groups like units, facilities, states, and the entire country. It evens out differences between health care facilities. The SIR compares the actual infections reported to the expected ones based on the 2015 baseline, which varies for each infection type and facility’s individual risk. Lower SIRs mean better performance. For more information see NHSN Standardized Infection Ratio - A Guide to the SIR (PDF).
A SIR is not calculated when the number of predicted infections is less than 1.0. According to the national baseline data, if the number of predicted infections is less than 1.0, the risk to patients is low enough that not even one type of event (or infection) is predicted to occur in that group of patients. For reporting purposes, the SIR can be assumed to be zero if it was not calculated.
Interpretation
Colors and symbols are used to make it easier for you to see if the SIR is statistically significant. They give you an idea about how well the facility or state is doing for that specific HAI.
| Interpretation | SIR Value | Meaning |
|---|---|---|
| Better than Expected | <1.0 |
There were fewer infections than predicted. If a facility has a SIR of 0.75, they experienced 25% fewer events than expected. |
| Same as Expected | 1.0 | The SIR ratio is not significantly different than 1.0, meaning the number of infections was close to or the same as predicted. |
| Worse than Expected | >1.0 |
There were more infections than predicted. If a facility has a SIR of 1.5, they experienced 50% more events than predicted. |
| No Conclusion | NA | There was not enough information to make a reliable comparison to the national experience. |
Observed Infections
Observed infections are the actual number of HAIs that occurred and were reported by a facility. These are identified using the NHSN surveillance definitions.
Predicted Infections
The predicted number of infections represents the number of infections that NHSN expects a facility to have, given its specific mix of patients, procedures, and risk factors. NHSN calculated this using multivariable regression models built from national baseline data.
95% Confidence Interval
The 95% confidence interval (CI) is a statistical range of values that likely contains the true value of an estimate. The two numbers in the CI are used to determine the significance and precision of the SIR. The wider the CI is, the less precise the SIR measurement is. The 95% CI also tells us whether the facility’s SIR is significantly different from 1, which is the value expected if the facility performed the same as predicted based on the national data. When the 95% CI contains 1.0, the facility’s SIR is not statistically different from what was expected.
Denominator Data
In NHSN, denominator data measure patient exposure. Hospitals are expected to count their patients daily for each HAI reported. The denominator data is the basic counts that show how much patient care or device use occurred. They are essential for calculating valid infection rates and SIRs. The denominator data type will differ depending on the HAI, and what patient group is considered at-risk.
Catheter Days
Catheter days are the total number of patients who have an indwelling urinary catheter in place when the facility does their daily counts. Daily counts are added together and used to measure how many people are considered at-risk for CAUTI.
Central Line Days
Central line days are the total number of patients who have a central line in place when the facility does their daily counts. Daily counts are added together and used to measure how many patients are considered at risk for CLABSI.
Patient Days
Patient days are the number of patients who are in a specific location when the facility does their daily counts. Daily counts are added together to see how many days of patient care occurred and how many patients are considered at risk for CDI and MRSA.
Procedure Count
Procedure count is the number of a specific surgery or procedure performed during a set time period. It is used to measure how many people are considered at-risk for a surgical site infection (COLO and HYST).