Healthcare-associated Infections

Emerging Infections Programs (EIP) Activities Funded

This Recovery Act supplement to EIP is to address the Department of Health and Human Services (HHS) Action Plan by using the existing EIP network, capacities, and infrastructure to support targeted efforts to monitor and investigate the changing epidemiology of Healthcare-associated Infections (HAI) in populations in the context of HAI prevention efforts thereby increasing the knowledge base in this area and facilitating improvements in HAI prevention efforts.

Evaluating HAIs in non-hospital settings.

Specific activities include:

Participate in protocol development with the EIP/Active Bacterial Core Surveillance MRSA Pathogen committee, obtain necessary approvals from all participating institutions, and complete necessary data collection.
Obtain necessary approvals to gain access to medical records from long-term care facility residents and patients recently discharged from acute care facilities.
Submit de-identified data to CDC for multi-site analysis in accordance with common protocol.

Innovations in surveillance through the NHSN.

Applicants must address activities A-D and at least one additional activity, but are encouraged to address all:

Identify or hire staff with expertise in HAI surveillance and prevention to oversee EIPs HAI activities. Ensure that staff involved in HAI activities receive necessary HAI training.
Establish a communication network of all NHSN facilities within the EIP catchment area and establish the EIP sites as a NHSN group user with specified rights to data from reporting facilities. This will allow the EIPs to conduct site-specific data analysis and reporting.
Promote the use of specific NHSN modules for reporting HAI-related data through NHSN at network facilities as measurement tools to evaluate specific research and non-research activities focused on HAI prevention. Participate via EIP Steering Committee and/or appropriate EIP network workgroups to determine EIPs catchment area and the specific focus of the data to be reported. This may include facilitating the use (through training and other activities) of the Multidrug-Resistant Organism (MDRO) and <em>Clostridium difficile</em>-associated Disease (CDAD) NHSN Module which is for MRSA and/or Clostridium difficileicile reporting.
Implement a hospital-wide HAI prevalence survey in accordance with a multi-site protocol developed by the EIP Network. The protocol will be based on CDC's pilot survey that is being performed in summer 2009. Activities will include protocol development, facility recruitment, leading training sessions with facilities, and conducting an expanded pilot survey in mid-2010 and a full point prevalence survey conducted over 1 month in 2011. This evaluation will be one mechanism to assess the accuracy and relevance of NHSN HAI data reported to state health departments and CDC.
Assess the role and potential for interruption of inter-facility transfer of MDRO's and CDI between healthcare facilities using a common methodology developed through the EIP Steering Committee and/or EIP network workgroups. Identify and address potential overlap with the HAI prevention collaboratives that are outside of the EIPs (e.g. hospital associations, local Quality Improvement Offices performing similar work through the 9th Scope of Work of CMS)
Improve NHSN reporting and operations user experience for facilities and state health departments. This will involve performing studies to evaluate alternative (i.e., simplified but valid) ways to perform: data acquisition, analysis, and dissemination of data (e.g., validate HAI related data, estimate denominator or numerator data, and simplify NHSN methods). Information obtained from the evaluation will be used to develop a model for NHSN reporting and operations that can be used by non EIP state health departments.
Establish a mechanism for collecting and submitting pathogens associated with emerging antimicrobial-resistance and evaluate this mechanism.

CDC activities for this program

In a cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant monitoring.

CDC activities for this program are as follows:

Organize monthly conference calls focused on EIP HAI-related activities to facilitate EIP development of common protocols, methods, and analysis.
Assist protocol development and informatics support as needed
Provide webinars, face-to-face meetings, and/or on-site assistance to facilitate implementation of common methodology to achieve objectives of specific activities
Host monthly state users support teleconference dedicated to NHSN use for state users.
Assist grantees with tracking performance measures and indicators and where necessary, integrating new and existing procedures to streamline data collection and minimize grantee's burden.