Example of information documents

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2015 Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey
Centers for Disease Control and Prevention (CDC) and Emerging Infections Programs (EIP)

Project Overview
What is the Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey project?
 It is a one-day survey of healthcare-associated infections (HAIs) and antimicrobial use in a sample of U.S. acute
care general and general children’s hospitals.
 CDC and the EIP conducted the first full-scale U.S. HAI and antimicrobial use prevalence survey in 2011. More than
180 hospitals in 10 states participated, and over 11,000 patients were surveyed.
 The survey provides critical information on the burden and types of HAIs affecting patients in U.S. hospitals and
on the use of antimicrobial drugs.
What did the 2011 survey accomplish? Why conduct another survey in 2015?
 The 2011 survey redefined the burden of HAIs and showed how antibiotics are being used in U.S. hospitals. Survey
results garnered national and international attention, and were published in the New England Journal of Medicine
(http://www.nejm.org/doi/full/10.1056/NEJMoa1306801) and JAMA
(http://jama.jamanetwork.com/article.aspx?articleid=1911328).
 Survey results influenced the creation of the “National Strategy for Combating Antibiotic-Resistant Bacteria” and
the President’s Council of Advisors on Science and Technology report on “Combating Antibiotic Resistance”:
o Survey data were used to generate national burden estimates for antibiotic-resistant infections in the
CDC’s report on “Antimicrobial Resistance Threats in the United States, 2013”
(http://www.cdc.gov/drugresistance/threat-report-2013/index.html), for the first time putting this
burden in context for the public and for policy makers.
o The survey provided national data on hospital antimicrobial drug use to highlight the potential for
improving prescribing in U.S. hospitals (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6309a4.htm)
and justify the need for policy changes outlined in the National Strategy to expand antibiotic stewardship
programs to all U.S. hospitals.
 Conducting another survey in 2015 is important to understand how HAIs and antimicrobial use are changing over
time in hospitals as more prevention and stewardship activities are implemented. It also provides the opportunity
to gather information that wasn’t collected in the 2011 survey. For example, in this new survey we will collect
more data about the quality of antimicrobial drug prescribing.
Doesn’t the CDC’s National Healthcare Safety Network (NHSN) provide similar information?
 The prevalence survey is designed to complement data reported to the NHSN; many HAIs detected in the
prevalence survey are not routinely reported to NHSN or other surveillance systems.
 There are no other CDC surveillance systems collecting patient-level information on the reasons for antimicrobial
use in acute care hospitals.
What is the Emerging Infections Program (EIP)?
 EIP is a network of 10 state health departments (CA, CO, CT, GA, MD, MN, NM, NY, OR, TN) and their
collaborators. EIP works with the CDC on a variety of infectious disease surveillance and prevention-oriented
projects, including this survey effort (go to http://www.cdc.gov/hai/eip/index.html for more information).
What are the main objectives of the 2015 survey?
 Estimate HAI prevalence in a large sample of U.S. acute care inpatients;
 Determine the distribution of HAIs by pathogen and major infection site across the spectrum of hospital locations;
 Estimate the prevalence and describe the rationale for antimicrobial use in a large sample of U.S. acute care
inpatients.
National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion

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CDC/EIP 2015 Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Overview

What hospitals are being asked to participate in the 2015 survey?
 Each EIP site will engage up to 25 acute care (including children’s) hospitals. We’d like all hospitals that
participated in the 2011 survey to participate in the 2015 survey. Participation is voluntary.
 Hospitals that are selected are not required to participate, but participation will help maintain the quality of the
survey methods and results. Hospitals do not need to participate in NHSN to join the survey.
What is the role of the hospital Infection Preventionist and other hospital personnel?
 Each hospital will be asked to identify a survey team made up of 1 or more staff members. This team is called the
“Primary Team,” or PT. The PT Leader should be an Infection Preventionist or Hospital Epidemiologist, if possible.
EIP staff will work with hospitals that do not have an Infection Preventionist available to identify another qualified
individual to fill this role. Other PT members are chosen by the PT Leader.
 The PT will work with EIP staff to select a survey date, which can be any weekday (Monday-Friday) from May 1
through September 11, 2015.
 Before the survey date, the PT Leader (or designee) will be asked to complete a questionnaire that asks about
hospital bed size, staffing, and hospital infection control and antimicrobial use policies and practices.
 A few weeks before the survey date, the PT will provide information about the hospital’s acute care inpatient units
and bed numbers to the EIP staff.
 On the survey date, the PT will obtain the morning inpatient census; this will be used to select a random sample of
patients to survey. The EIP staff will do most of the work to generate this random sample.
 Data collected by PTs will include patient demographics; central line, urinary catheter, and ventilator use; height
and weight; and whether the patient is on antimicrobials at the time of the survey.
 Data collection by the PT will be limited to the day of the survey. EIP staff will later collect detailed information
from medical records about HAIs and antimicrobial use.
 If you have concerns about PT activities or time commitment, please discuss these with your EIP contact to
explore options that may allow your hospital to participate.
How will the data be kept confidential?
 CDC and EIP sites will know the identities of the hospitals that are selected to participate and the identities of
hospitals that actually participate in the survey.
 Data will be collected from existing medical records only. There is no direct interaction with patients.
 No patient identifiers, other than selected dates (such as admission and discharge date) will be shared with the
CDC. However, the PT will need to collect patient identifiers and share them with the EIP team.
 Survey records will use ID codes instead of hospital names and patient names; these codes will not be based on
information that could be decoded to identify a hospital or patient. Links between codes and identifiers will be
kept in secure locations in hospitals and EIP sites, and will not be shared with CDC.
 CDC will analyze and report aggregated data, within an EIP site or across all EIP sites.
 Patient identifiers (except selected dates and clinical information) that are collected and maintained in a secure
manner by the PT or EIP team will be destroyed after survey activities are complete, or in accordance with local
rules and regulations.
What are the benefits to my hospital from participating in the 2015 survey?
 This project will build upon the findings of the 2011 survey, informing national surveillance and prevention efforts.
 Participating hospitals will gain experience in prevalence survey methods that could be used in hospital-level
infection control and antimicrobial stewardship-related assessments.
 Because we are minimizing the workload, hospitals will not survey enough patients to get precise estimates of
HAIs and antimicrobial use at the hospital level. However, CDC and/or EIP staff will provide overall survey results
to participating hospitals after the survey is completed.
 A letter or certificate of appreciation from the CDC and the EIP site will be provided to survey participants.
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 Hospitals and staff may choose to be acknowledged by name in presentations or publications of survey results.

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CDC/EIP 2015 Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Overview

How much time is required to participate?
6-8 weeks before the survey:
 For some hospitals, time may be needed to prepare and submit an Institutional Review Board (IRB) application to
your hospital’s IRB. Your hospital may or may not require IRB review. Your EIP contact should be able to help you
with this. We estimate it may take 2 hours to prepare an IRB application, using materials provided to you by your
EIP contact.
4 weeks before the survey:
 You will provide a list of your hospital’s acute care inpatient units to your EIP contact, who will map each of these
units to NHSN location codes (if not already mapped). We estimate it may take 1-2 hours to assemble the unit list
and provide the EIP contact with descriptions of the types of patients cared for in those units. More time may be
needed (e.g., 5 hours) in hospitals that have not already mapped their inpatient units for NHSN.
 You and other PT members may be asked to participate in a 1 hour training session. Training will be done via
webinar or in person in your hospital. We will work to arrange the training for a convenient time.
 You and/or other PT members will complete a “Healthcare Facility Assessment;” this questionnaire, new in 2015,
will provide information about infection control and antimicrobial stewardship in hospitals participating in the
survey. We estimate that this questionnaire will take 45 minutes to complete.
Morning of the survey (between 12:00 am and 8:00 am):
 You will obtain a hard copy of your hospital’s inpatient census for the survey day.
On the survey day (during normal working hours):
 The PT will conduct basic medical record reviews on 75-100 randomly-selected patients.
 Most hospitals will survey 75 patients (if your hospital has fewer than 75 patients, you will survey all acute care
inpatients); large hospitals will survey 100 patients.
 We estimate that it will take 5-6 hours for 3 people to collect data on 75 patients, and 7-8 hours for 3 people to
collect data on 100 patients.
After the survey day:
 You may be asked to provide limited assistance to EIP staff during the time they are reviewing medical records of
surveyed patients in your hospital. This will not include any additional medical record review on your part, but
might include activities such as orienting EIP staff to your medical records department and/or medical record
system.
Estimated total time commitment (preparation, training, record review and data collection):
 Small or medium-size hospital, 75 patients surveyed, 3-person PT: 8 to 15 hours
 Large hospital, 100 patients surveyed, 3-person PT : 10 to 17 hours
For more information: Contact your EIP site. We will be happy to address any questions or concerns you may have
about the survey, and will work with you to find ways to reduce the burden so that you and your hospital are able to
participate.
EIP contact name:
Email address:
Phone number:
Alternate Phone Number (mobile):
EIP contact name:
Email address:
Phone number:
Alternate Phone Number (mobile):

Thank You!

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