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MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio Passcode: 9103755 Webinar: http://breeze.mdch.train.org/mdchsharp/ Enter meeting room as guest, then type your last name and affiliation if you feel comfortable doing so. Meeting room may prompt for Add-On, click yes. Please turn-off any pop-up blockers to help limit problems with the application. Please send any questions, comments, or suggestions about these calls to Sara McNamara at [email protected]. If you have never attended a Connect Pro meeting before, you can test your connection at: http://breeze.mdch.train.org/common/help/en/support/meeting_test.htm NOTE: Please place your phone on mute or press *6 to mute. Do not place your phone on hold as this will cause those on the conference call to hear music or messages that your hospital gives out. If you have to answer another phone call, please hang up and call back into the meeting room after you finish taking the call. THANK YOU! Agenda: 1. Welcome & Introductions 2. Update on Surveillance Initiative and Reports 3. NHSN Updates and Correspondence 4. SHARP Updates 5. Questions/Discussion 6. Next Meeting – February 28th, 2018 at 10am
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MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

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Page 1: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

MDHHS SHARP NHSN USERS CONFERENCE CALL

Wednesday, December 20th, 2017 10:00 a.m.

Audio Call-in Number: 877-336-1831 Audio Passcode: 9103755

Webinar: http://breeze.mdch.train.org/mdchsharp/ Enter meeting room as guest, then type your last name and affiliation if you feel comfortable doing so. Meeting room may prompt for Add-On, click yes. Please turn-off any pop-up blockers to help limit problems with the application. Please send any questions, comments, or suggestions about these calls to Sara McNamara at [email protected]. If you have never attended a Connect Pro meeting before, you can test your connection at: http://breeze.mdch.train.org/common/help/en/support/meeting_test.htm NOTE: Please place your phone on mute or press *6 to mute. Do not place your phone on hold as this will cause those on the conference call to hear music or messages that your hospital gives out. If you have to answer another phone call, please hang up and call back into the meeting room after you finish taking the call. THANK YOU!

Agenda:

1. Welcome & Introductions

2. Update on Surveillance Initiative and Reports

3. NHSN Updates and Correspondence

4. SHARP Updates

5. Questions/Discussion

6. Next Meeting – February 28th, 2018 at 10am

Page 2: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Michigan NHSN User Group CallDECEMBER 20, 2017

Page 3: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

SHARP Reports• Individual Facility TAP Reports have been sent

• 2016 Q1 – Q4 & 2017 Q1

• Aggregate TAP Reports have been posted to: www.michigan.gov/hai• 2016 Q1 – Q4 & 2017 Q1 TAP Reports, Overall and by Region• Revised 2015 Annual Report

• Coming Soon• 2017 Q2 TAP Report• 2016 Annual Report

Page 4: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Updated TAP Reports• 2015 Baseline data

• CAUTI, CLABSI, CDI, SSI COLO, SSI HYST: SIR, CAD, CAD graphs (in Aggregate Reports)

• Total VAE, IVAC, MBI-CLABSI: SIR

• Central Lines, Urinary Catheters, Ventilators: SUR

Page 5: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Aggregate TAP Report

Page 6: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

New NHSN Reports• 2015 National and State HAI Data Report

• Includes SIR data by nation and States, as well as national standardized utilization ratios (SUR) using 2015 Baseline

• No comparisons made between previous year data and current year data• Produced by facility type (e.g., ACH, CAH, IRF, LTAC)• Includes fact sheets and detailed technical tables

• National 2015 SIRs using Historical Baselines• Includes SIR national data using original baseline for acute care hospitals for CLABSI, CAUTI, SSI COLO

and HYST, MRSA bacteremia and C. difficile LabID• Comparison between 2014 and 2015 national SIRs • Additional metrics: device-utilization, pathogen distributions, inpatient community-onset prevalence

rates

Page 7: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

New NHSN Reports• Healthcare-Associated Infections in the United States, 2006-2016: A Story of Progress

• High-level assessment using NHSN and other data using both historical and 2015 baselines• Includes CLABSI, CAUTI, SSI, CDI, MRSA bacteremia• Covers: HHS Action Plan goals, changes in SIR over time, EIP data, next steps

• All reports will be available in January 2018 on NHSN website

Page 8: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

NHSN Updates

Page 9: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

NHSN v8.8 Release Notes• In production as of 12/2/17

• Annual Survey includes 3 questions on water management for control of Legionella

• Pathogen lists updated; updates will apply to events dated 1/1/18 and forward

• FacWideIn denominator reporting for LTAC and Rehab simplified

• CDI Test Type added to MDRO denominator reporting for IRF units

• Procedures, SSI, and locations will allow all genders

• BSI events have optional fields for presence of ECMO and VAD

• Criteria updates for IAB and GIT

• APRV field now optional for ICU/other summary, SCA summary, and VAE events

https://www.cdc.gov/nhsn/pdfs/commup/release-notes-8.8.pdf

Page 10: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

NHSN v8.8 Release Notes• Updates to SIR and Rate tables

• CMS analysis datasets will use CCN history to assign the CCN for each month (summaryYM) based on the CCN that was in effect for the corresponding time period

• For SIR/Rate table reports using these analysis datasets:• CCN added as a default column in the table to the right of OrgID column• CCN has been removed from the Page by column headings

• VAE SIR for ‘Total VAE’ now available for critical access hospitals (no IVAC Plus SIR)

• Conferred rights listing report for Groups, changed naFlag to Y/N/.• Y – naFlag checked and current rights template accepted• N – naFlag not checked and current rights template accepted• . – current rights template has not yet been accepted

Page 11: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

NHSN v8.8 Release Notes• AU Updates

• Delafloxacin has been added to CDA; optional for 2018, required for 2019• ‘Bar Chart – All Data – Selected Agent Distribution by Month’ report now available. Allows the user to

select one or more drugs and see their usage by location and month in a stacked vertical bar chart.• AU variables added to Monthly Reporting Plan Line List

•AR Updates• ‘Missing Summary Data’ alerts removed for outpatient locations submitting AR data (24-hr Obs, ED,

PedED)• 6 ESBL organisms can be reported as AR option events• AR variables added to Monthly Reporting Plan Line List

Page 12: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Delayed Changes – NHSN v8.8.1• NHSN v8.8.1 scheduled for release January 23, 2018

• NHSN Agreement to Participate and Consent form• Facility Administrators and Primary Contacts will be able to view and accept the updated agreement

beginning with v8.8.1• Agreement must be accepted by April 14, 2018 or risk losing NHSN access

• ICD-10-PCS/CPT Operative Procedure Code Update • Review and validation process for FY2017 and 2018 CMS ICD-10-PCS procedures is in progress• Revised list of NHSN procedure codes will be available for use during the v8.8.1 release • Advise users to delay entering operative procedures that are performed on or after January 1, 2018 until

v8.8.1 deployment is complete

Page 13: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Reporting Height and Weight for Operative Procedures

• SSI SIR models include BMI calculations based on reported patient height and weight

• BMI outliers are excluded from SIR calculations (e.g., adults with BMI less than 12 or greater than 60 kg/m²)

• NHSN has noticed a number of 2017 procedures with BMIs of 1 or greater than 500 or 2000 kg/m², which could represent data quality issues

Height is reported in either feet/in or meters – only one should be entered

Weight is reported in pounds or kilograms – only one should be entered

https://www.cdc.gov/nhsn/pdfs/commup/reporting-height-weight-procedures.pdf

Page 14: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

How to Search and Edit for Procedures with Extreme BMI

• In Analysis Reports, select Advanced -> Procedure-level Data -> Line Listing – All Procedures report• Then select ‘Modify Report’

Page 15: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

How to Search and Edit for Procedures with Extreme BMI

• Modify the report to include height and weight variables

Page 16: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

How to Search and Edit for Procedures with Extreme BMI

• Review the output for any inaccurate data

Page 17: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

How to Search and Edit for Procedures with Extreme BMI

• Find and edit the procedure record with correct data

Page 18: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

NHSN Release Management and Issues Webpage

• Provides a timeline of the NHSN Release Schedule

• Provides a list of all current known NHSN defects impacting the application, including those that may impact CMS reporting

https://www.cdc.gov/nhsn/releasemgt/index.html

Page 19: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Updated Training Website• New layout for training materials in response to requests for increased navigability and more streamlined access to training activities and materials

• Changes scheduled to go live in early 2018

https://www.cdc.gov/nhsn/pdfs/commup/update-training-website.pdf

Page 20: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Training Component Pages• Training Videos

• Self-paced interactive trainings

• Quick Learns

Page 21: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

New Analysis Reports Quick Learn Posted• 10 minute video with guidance covering data entry, analysis report options, making modifications to reports, and exporting data from NHSN

https://www.cdc.gov/nhsn/ps-analysis-resources/index.html

Page 22: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

New NHSN Case Study in AJIC• December 1, 2017 issue

• Case reviews application of the PNEU criteria, secondary bloodstream infections, and the RIT

• An online survey accompanies the case where participants can answer questions and receive immediate feedback on answers with explanations

http://www.ajicjournal.org/article/S0196-6553(17)31062-3/fulltext

Page 23: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

SHARP Updates

Page 24: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Reporting Changes on the HorizonDisease/Condition

Required to be Reported

New Condition in MDSS

New Standardized Case Definition

New form in MDSS

Carbapenemase-Producing Carbapenem-Resistant

Enterobacteriaceae (CP-CRE)Y Y Y Y

Perinatal Hepatitis CY - no changes to current reporting

requirementsY Y Y

Perinatal Hepatitis BY - no changes to current reporting

requirementsN N N

Candida auris Y – Unusual Occurrence

N Y N

Extrapulmonary Non-Tuberculous Mycobacterium (NTM) N - Optional N Y Y

Latent Tuberculosis Infection (LTBI) N - Optional Y Y Y

Page 25: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

CP-CRE Reporting• ELR Reporting into MDSS

• Rely on manual entry into MDSS

• CRE Case Investigation Form• Follow form for gathering information needed• If novel resistance mechanism investigation, you will be contacted by the SHARP unit

Page 26: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Novel Resistance Mechanisms• The Bureau of Laboratories has expanded test offerings to include:• Confirmation of carbapenemase production and colistin resistance• Genetic markers for KPC, NDM, VIM, OXA-48, and MCR-1

• IMP assay coming soon!• Enterobacteriaceae, Acinetobacter, and Pseudomonas aeruginosa

Page 27: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Additional changes to the 2018 Michigan Reportable Disease Lists:

• Removed rheumatic fever from the list of diseases or conditions required to be reported.

• Removed the footnote (4) designation from HIV infection. Isolates, subcultures, or specimens are no longer required to be submitted to the MDHHS Lansing laboratory for HIV infections.

• Added Bacillus cereus serovar anthracis under the anthrax category as required to be reported and as a designated category A bioterrorism agent.

• Modified Coxiella burnetii (Q Fever) to be a designated category A bioterrorism agent.

• Modified Eastern Equine Encephalitis to be a designated category A bioterrorism agent.

• Modified Severe Acute Respiratory Syndrome (SARS) to be a designated category A bioterrorism agent.

• Added Hepatitis A Virus genotype testing as a reportable lab result.

Page 28: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

SHARP Unit Additions Coming Soon….• NHSN Epidemiologist – hired within the next few weeks

• Antimicrobial Stewardship Coordinator – looking to hire this position to run the Communities of Care and Antimicrobial Use and Resistance (AUR) Module Pilot project• Posted to MPHI’s website early January 2018

Page 29: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

https://www.surveymonkey.com/r/MiCRELab https://www.surveymonkey.com/r/MiCREIP

Page 30: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Next Michigan NHSN User Group Call

Wednesday, February 28, 2018 at 10 AM

Page 31: MDHHS SHARP NHSN USERS CONFERENCE CALL ...2017+NHSN+Users...MDHHS SHARP NHSN USERS CONFERENCE CALL Wednesday, December 20th, 2017 10:00 a.m. Audio Call-in Number: 877-336-1831 Audio

Thank you!Surveillance for Healthcare-Associated and Resistant Pathogens (SHARP) Unit

www.michigan.gov/hai

Brenda Brennan, MSPH – SHARP Unit Manager, HAI & CRE Prevention Coordinator, [email protected]

Chardé Fisher, MSW – Health Educator, [email protected]

Sara McNamara, MPH, MT(ASCP) – Antimicrobial Resistance Epidemiologist, [email protected]

Noreen Mollon, MS CIC – Infection Prevention Consultant, [email protected]