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Administrator
Posts: 578
Registered: ‎02-22-2010

CMS and NHSN in 2013 Webinar

[ Edited ]

Thanks for joining Joan Hebden in her webinar. 

View the on-demand recording or download the slides.

 

Have a question for Joan? Please post them here and she will answer your questions as best as she can.

Occasional Visitor
Posts: 1
Registered: ‎01-30-2013

Re: CMS and NHSN in 2013 Webinar

In Pa. we were told to enter all c diff + into lab id and then reenter any HAI c diff as an event. This seemed to be different than what was presented today. Is this state specific did I misunderstand? Thanks

Occasional Visitor
Posts: 1
Registered: ‎06-28-2012

Re: CMS and NHSN in 2013 Webinar

Great presentation!  One of the last questions asked during the webinar was about outpatients and when they are considered, or need to be counted in the patient counts.  An outpatient would need to be included in the inpatient patient days if their date of admission and date of discharge are different days, correct?  That definition hasn't changed, unless I'm a lot more screwy in my thinking than I think I am!!  I have a couple other questions....

Why the big distinction between the previous '48 hours' and new >2 calendar days?  I may be looking at things all wrong, but I took that to mean that should I find an element present (fulfilling a definition criteria), and it had been present within the past 48 hours, it should be counted as a HAI.  When did a 'calendar day' become either more or less than 24 hours? 

My next question has to do with the example given in the webinar of the patient that had experience diarrhea for the past three days, presents on day three to the ED, has a stool sample tested for CDiff, with a positive result and is subsequently admitted.  If I am doing FACWIDIN reporting, how is this patient counted in that?  They haven't been and Inpatient but for day one (admission day).  Later, you showed a slide that said to report a LABID CDI, the patient needed to have had the testing done >3 days after admission. 

Just when I thought I'd kind of, sort of, maybe, PERHAPS understood something........ Smiley Sad 

Thank-you!  Kelley Newsom, BSN, RN - Kelley.Newsom@newmedctr.org

Occasional Visitor
Posts: 1
Registered: ‎01-30-2013

Re: CMS and NHSN in 2013 Webinar

Our hospital policy for recording temps is to record the temp value and the route taken.  There is no policy statement about converting to an oral equivalent.  Without a written policy, how would someone that reviews or validates whether I'm submitting data correctly determine if a temp meets criteria for infection?  Should I adjust to an oral equivalent or take the temps at face value?

Pharmacy OneSource
Posts: 6
Registered: ‎01-11-2012

Re: CMS and NHSN in 2013 Webinar


Kmow wrote:

In Pa. we were told to enter all c diff + into lab id and then reenter any HAI c diff as an event. This seemed to be different than what was presented today. Is this state specific did I misunderstand? Thanks


Great question.  The material covered today for LabID event reporting was based on CMS requirements.  State requirements may differ and in your case they do.  You are being asked to enter any C. diff toxin positive assay that meets FACWIDEIN LabID event reporting  into NHSN AND to separately report the healthcare-associated C. diff events as HAIs.  REMEMBER – LabID event reporting represents a proxy measure for infection and therefore,  is not the same as HAI surveillance.  

 

Pharmacy OneSource
Posts: 6
Registered: ‎01-11-2012

Re: CMS and NHSN in 2013 Webinar

[ Edited ]

Knewsom wrote:

Great presentation!  One of the last questions asked during the webinar was about outpatients and when they are considered, or need to be counted in the patient counts.  An outpatient would need to be included in the inpatient patient days if their date of admission and date of discharge are different days, correct?  That definition hasn't changed, unless I'm a lot more screwy in my thinking than I think I am!!  I have a couple other questions....

Why the big distinction between the previous '48 hours' and new >2 calendar days?  I may be looking at things all wrong, but I took that to mean that should I find an element present (fulfilling a definition criteria), and it had been present within the past 48 hours, it should be counted as a HAI.  When did a 'calendar day' become either more or less than 24 hours? 

My next question has to do with the example given in the webinar of the patient that had experience diarrhea for the past three days, presents on day three to the ED, has a stool sample tested for CDiff, with a positive result and is subsequently admitted.  If I am doing FACWIDIN reporting, how is this patient counted in that?  They haven't been and Inpatient but for day one (admission day).  Later, you showed a slide that said to report a LABID CDI, the patient needed to have had the testing done >3 days after admission. 

Just when I thought I'd kind of, sort of, maybe, PERHAPS understood something........ Smiley Sad 

Thank-you!  Kelley Newsom, BSN, RN - Kelley.Newsom@newmedctr.org




Q: One of the last questions asked during the webinar was about outpatients and when they are considered, or need to be counted in the patient counts.  An outpatient would need to be included in the inpatient patient days if their date of admission and date of discharge are different days, correct?  That definition hasn't changed, unless I'm a lot more screwy in my thinking than I think I am!!  I have a couple other questions....

 

I do not believe that your interpretation regarding inclusion of outpatients with different admit and DC dates into the inpatient day denominator is correct. Inpatient days represent days in an INPATIENT LOCATION.  Please refer to the NHSN Resource Library – Locations/ Mapping.  

 

Q: Why the big distinction between the previous '48 hours' and new >2 calendar days?  I may be looking at things all wrong, but I took that to mean that should I find an element present (fulfilling a definition criteria), and it had been present within the past 48 hours, it should be counted as a HAI.  When did a 'calendar day' become either more or less than 24 hours?

 

Please refer to my slide on the definition of HAI and see the attached document of the 2013 NHSN changes.  There is no longer any reference to 48 hours – everything has been changed to >2 calendar days due to easier capture by electronic databases.

 

Q: My next question has to do with the example given in the webinar of the patient that had experience diarrhea for the past three days, presents on day three to the ED, has a stool sample tested for CDiff, with a positive result and is subsequently admitted.  If I am doing FACWIDIN reporting, how is this patient counted in that?  They haven't been and Inpatient but for day one (admission day).  Later, you showed a slide that said to report a LABID CDI, the patient needed to have had the testing done >3 days after admission. Just when I thought I'd kind of, sort of, maybe, PERHAPS understood something........

 

Please refer to slide 32 for explanation. The patient was counted because they were admitted to an inpatient location on the SAME day that the positive C. diff toxin assay  was collected in the ED.  In respect to the second part of your question – I was clarifying that although IPs are to submit LabID events to NHSN for C. difficile that may not represent healthcare-associated infections, NHSN will ONLY submit HO-onset cases to CMS - >3 days after admission    

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Pharmacy OneSource
Posts: 6
Registered: ‎01-11-2012

Re: CMS and NHSN in 2013 Webinar


sdooley wrote:

Our hospital policy for recording temps is to record the temp value and the route taken.  There is no policy statement about converting to an oral equivalent.  Without a written policy, how would someone that reviews or validates whether I'm submitting data correctly determine if a temp meets criteria for infection?  Should I adjust to an oral equivalent or take the temps at face value?


If you do not have a facility policy that directs you to convert temperatures, then the value recorded in the medical record would be used.