Q: According to the CCS Supplemental form, does CLABSI refer to any bacterial infection or any bug, not just Staphylococcus epidermidis?
A: Any CCS NICU patient with a CLABSI event as defined by CDC/NHSN is counted on the form. Please refer to CDC/ NHSN site: http://www.cdc.gov/nhsn/acute-care-hospital/clabsi/ for definitions. Please note that we are looking at CLABSI on NICU patients ONLY, regardless of GA or admission date.
Q: What if the patient is greater than 28 days and not a CPQCC kid?
A: As long as the infant was in the NICU and meets the qualifications in the answer above, you would record this patient as well.
Q: On the CCS Form for 2013, Section F, #4 requests a number of NICU days of IM or IV antibiotic exposure for any purpose in all infants. Does that mean how many days in 2013 did pharmacy send us antibiotics? OR how many patients each day received antibiotics in 2013? Please advise.
A: It means, the number of days the infant received treatment with antibiotics, as per the definition, please note below:
Antibiotic Use Rate:
- To assess antibiotic use, enter the number of days an infant in your NICU was exposed to treatment with antibiotics. For this item, antibiotics include antibacterial and antifungal agents, not however antiviral agents.
- The antibiotic use rate is calculated as the ratio of the number of days an infant in your NICU was exposed to treatment with antibiotics (numerator) and the total number of patient days for all on-site licensed NICU beds entered in Section E (denominator).
The measure aims to count the proportion of total patient days in a year in which babies received some antibiotic. For example, if you had 10 patients in your NICU every day last year, and on each day there were 3 patients receiving some antibiotic:
- 3 antibiotic patient days each day X 365 days in the year = 1095 antibiotic patient days
- 10 patients in NICU each day X 365 days in the year = 3650 patient days
Q: For number of days - they want every day that EVERY patient had a central line in one big total, say we had 20 kids under 750 and they all had a central line for 20 days -I would enter 400 days? This would mean looking up EVERY patient we've had all year and getting a total number for each weight class right? AND for the antibiotic exposure are we talking EVERY NICU patient - or just those that had a central line? It seems to read EVERY infant - including those not counted by CPQCC? And the total number of patient days for all on-site licensed NICU beds entered in Section E (denominator). - DOES THIS MEAN THE total number of patient days for the entire year meaning the total amount of days every kid admitted to the NICU in 2013 spent in the NICU?
A: The answer to each of your questions is yes. For central line-days and total patient days, the numbers are already tracked by your infection control professional that reports your hospital’s data to NHSN in compliance with CDPH requirements. Antibiotic days count every patient in the NICU. Probably the most efficient and accurate way to compute this number is for your pharmacy to write a query for the CPOE system. Once the query is written, computation in subsequent years should be easy.
Q: Please clarify what “the number of days an infant in your NICU was exposed to treatment with antibiotics” means. Is it per the number of antibiotics given or just number of days regardless of the number of antibiotics given?
A: It's the number of days an infant was exposed to treatment regardless of number of antibiotics.