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HAI Validation

Validation Studies

The Oregon Public Health Division performs independent validation of healthcare facility reported National Healthcare Safety Network (NHSN) surveillance data to ensure accurate and complete reporting of Oregon healthcare-associated infection data.

Validation studies allow us to:

  • Monitor accuracy of data submitted by hospitals to NHSN
  • Assess healthcare facility surveillance systems and their use of NHSN definitions
  • Ensure that healthcare facilities are reporting infections in a consistent fashion

On this page:

Central Line-Associated Bloodstream Infection (CLABSI) Validation

A central line-associated bloodstream infection is a serious infection that occurs when bacteria enter the bloodstream through a central line. A central line is a catheter (tube) that healthcare providers place in a large vein in the neck, chest, or arm to provide fluids, blood, or medications. Commonly found in an intensive care unit (ICU) setting, central lines are different from short-term intravenous catheter’s (IVs) because they terminate in major veins close to the heart. They can remain in place for weeks or even months and are much more likely to cause a serious infection.

CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable. According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 250,000 CLABSI cases occur each year in U.S. hospitals, resulting in a range of 30,000 to 62,000 deaths. It is estimated that U.S. hospitals spend up to 2.68 billion dollars annually to manage CLABSI cases.

2014 Validation Study

Oregon Public Health Division is performed a statewide validation of ICU CLABSI and denominator data in 2012 using a targeted sample of 23 Oregon hospitals. 

2011 Validation Study

In 2011, the Oregon Public Health Division completed a statewide validation of ICU CLABSI data reported by 44 hospitals during 2009 to determine the accuracy of data submitted by hospitals to NHSN during the first reporting year. Validation focused on assessing hospital surveillance systems and their use of NHSN definitions. Such validation projects ensure that hospital surveillance systems consistently apply NHSN CLABSI definitions.

Surgical Site Infection (SSI) Validation

Surgical site infections are infections that occur after surgery in the part of the body where the surgery took place. Though SSIs can sometimes be superficial infections, involving only the skin, other times SSIs can be deeper and involve tissues beneath the skin in organs, or implanted material. Validation of SSI data is necessary to ensure accurate hospital reporting.

The Oregon Public Health Division conducted a data validation study of SSIs occurring in patients hospitalized in Oregon for coronary artery bypass graft (CABG) procedures performed in 2009 and 2010.

Staff reviewed the accuracy of data submitted by 14 hospitals that reported CABG SSI data during 2009 and 2010 to NHSN, assessed hospital surveillance systems, and evaluate the use of NHSN definitions. The validation will occurred between September 2011 and June 2012. The findings of this validation project provided guidance to hospital staff on their use of surveillance definitions and reporting methods, and included recommendations for future validation studies.

Dialysis Event Validation

Dialysis patients are at risk of infection from pathogens that can spread from contaminated surfaces and hands to their bloodstream through dialysis access points. Nationwide, about 370,000 individuals with end-stage renal disease rely on hemodialysis and it is important to monitor adverse dialysis events as part of patient safety and quality improvement efforts. According to the CDC an estimated 37,000 dialysis-related bloodstream infections occur annually, with an episode of infection costing up to $28,000.

Validation of data is necessary to ensure accurate reporting of dialysis events. The Oregon Public Health Division conducted a data validation study in 14 Oregon outpatient hemodialysis facilities. Validation occurred August 2018 through March 2019; efforts included chart review assessments to monitor the accuracy of data submitted to NHSN and evaluation of the facilities’ knowledge and practices around NHSN surveillance.

The findings of this validation will be used to develop guidance to outpatient hemodialysis facility staff to assist with their surveillance, internal validation, and use of their NHSN data for action.