FAQs: Antimicrobial Use (AU) Option
Q1: I’m interested in submitting data into the AU Option. Where do I start?
If not already enrolled in NHSN, follow the 5-step process here: 5-Step Enrollment for Acute Care Hospitals/Facilities. If your facility is already enrolled in NHSN and now wants to participate in the AU Option, by submitting AU data to NHSN, then be sure your facility has the ability to obtain the data from either an electronic medication administration record (eMAR) or bar-coding medication administration (BCMA) system. Your facility also should have the ability to package the data into the standardized format of Clinical Data Architecture (CDA) for upload into NHSN.
Manual entry of AU data is not allowed due to the amount of data submitted each month. As a result, many facilities use a vendor system to package and submit the AU data via CDA. There are a number of self-identified vendor systems listed on the Society for Infectious Disease Pharmacists websiteExternal. You may already use one of these vendors currently for the submission of other types of data to NHSN so start there to see if 1) your facility has the capability to submit these data already using your current vendor or 2) your current vendor offers this capability with an “add on” feature. Some facilities are able to leverage internal IT/informatics resources to report these data. However, this does take specialized knowledge of coding and data aggregation and is not recommended for most facilities.
You can find the details on what data are required to be reported on our NHSN AUR Module webpage, within the training slides and protocol.
If your facility is interested/considering taking up this work internally, you’ll find the AU and AR CDA toolkits which contain the sample CDA files, link to the CDA Implementation Guide, helpful hints, etc. here: NHSN CDA Submission Support Portal (CSSP).
Q2: I’ve received my SAMS card and now have access to my NHSN facility. How do I submit my AU data to NHSN?
Now that you have access to NHSN, you must set up your monthly reporting plan before submitting your AU data. See question #13 for further details on how to create a monthly reporting plan. The CDC recently developed a 12-minute Quick Learn video discussing uploading CDA files into NHSN to help facilities with this process.
Q3: Is reporting to the NHSN AUR Module currently required for CMS? If not, could you tell me when it will be required for hospitals to report data into that module?
CMS has not included Antimicrobial Use and Antimicrobial Resistance Option reporting in the Hospital Inpatient Quality Reporting Program. However, the submission of data into the NHSN AU and AR Options via Clinical Document Architecture (CDA) is part of Meaningful Use Stage 3 for Public Health Registry reporting for eligible hospitals as outlined on the NHSN CDA Submission Support Portal (CSSP) Meaningful Use page. Submitting AUR Module data into NHSN will be the only part of NHSN reporting that qualifies for Stage 3 participation. Additional details regarding Meaningful Use can be found here: CDC Meaningful Use.
Q4: On my Meaningful Use Stage 3 (MU3) report it shows “No” by AU and AR data, yet our facility has submitted data. Why is this?
Your CDA file needs to be created using specific requirements in order to qualify for MU3 reporting. First, confirm that your data were successfully uploaded by generating your data sets within NHSN and running a line list. If your data show up in the line list, we suggest you speak with your vendor to determine why your submitted CDA data are not showing up on the MU3 report.
Q5: My facility no longer plans to use AUR reporting to meet MU3. Can I remove my MU3 intent to submit?
There is not currently a way to remove the MU3 registration within NHSN. Since your facility has registered its intent for MU3 within NHSN, you will receive the automated monthly status report emails. You can just disregard these if you do not plan to participate.
Q6: I’m planning to submit AU and AR data into my NHSN facility. Is there a deadline for getting these data into NHSN each month?
There are no timeline requirements for NHSN AUR data submission. However, we recommend that data be uploaded into NHSN within 30 days following the completion of the month to make the data most actionable. There are no ramifications for submission beyond this recommended timeframe. Further, we encourage facilities to upload retrospective data, if available, after their initial implementation.
Q7: How far back can we submit AU Option data?
A facility can submit AU Option data as far back as January 2012, if they have existing Monthly Reporting Plans during that time, or January of the previous calendar year (if no Monthly Reporting Plans previously existed).
Below are two scenarios to help explain this:
- Facility A has existing NHSN Monthly Reporting Plans going back to January 2016. They can edit the Monthly Reporting Plan to add AUR Module locations for back to January of 2016 and hence submit AU Option data back to January 2016.
- Facility B does not have any Monthly Reporting Plans in NHSN (meaning they didn’t even have reporting plans for HAI data). They can add Monthly Reporting Plans going back to the January of the year they enrolled in NHSN or back to the January of one calendar year in the past, whichever comes first.
- If the facility enrolled in January 2017 and it’s December 2017: they can add Monthly Reporting Plans with AUR Module locations back to January 2017 and hence submit AU Option data back to January 2017.
- If the facility enrolled in January 2015 and it’s December 2017: they can add Monthly Reporting Plans with the AUR Module locations back to January 2016 and hence submit AU Option data back to January 2016.
Q8: My pharmacist has requested access to NHSN to upload data into the AU Option. How do I add her as a user?
Follow these steps to set up your pharmacist as a user in NHSN:
- From the NHSN Homepage, navigate to Users on the left-hand side menu.
- Select Add User.
- Complete all fields marked with a red asterisk (*) and select Save.
- On the next screen, assign user rights and select Save. Pharmacists need rights to the Patient Safety Component in order to submit and/or view AU data. If your pharmacist will be submitting the AU data, Administrator-level user rights are recommended.
For complete details, please refer to the AU User rights document found here: NHSN AU User Rights Cdc-pdf[PDF – 350 KB].
Q9: Who can see my facility’s AU data in NHSN?
Once the data are uploaded into NHSN, only users of your NHSN facility have access to it. No outside groups are given access to view your data without your facility’s permission. There is a special option for Groups (such as a corporate healthcare system or a state health department) to request rights to view your facility’s data, but you would have to accept those rights before your data would be shared with them. Because these data are not included in any CMS quality reporting programs, they are not shared with CMS.
Q10: How do I delete AU data?
You can delete AU data following the steps below:
- From the NHSN Homepage, select Summary Data then Delete AUR Data on the left-hand side menu.
- Select the Summary Data Type, Location, Month and Year to be deleted. Then click the Delete button.
To update an existing record with new information, you can use succession management. Specifics on succession management can be found at NHSN CDA Submission Support Portal (CSSP).
Q11: I logged into my facility and can see that I have alerts for missing AU data. How do I get rid of them?
You can clear the missing summary data alerts by:
- Submitting the data for that location/month
- Removing those locations from the monthly reporting plan(s).
The alerts don’t affect your AU data in any way. Instead, the NHSN alerts are reminding you that you listed something in your reporting plan for a given month for which you have not yet submitted to NHSN.
Q12: I’m from a state health department. Could you tell me the names and NHSN OrgIDs of the facilities submitting AU and AR data from my state?
The NHSN team is not permitted to share identifying facility information such as NHSN OrgID or facility name with state health departments. We can provide you with the number of facilities submitting AU/AR data within your state. However, if you’d like facility-specific information, you can provide us with an email requesting this information, including your contact information, which we can forward to your state’s AU/AR submitters. Facilities can then contact you directly if they so choose but are not obligated to do so.
Q13: How do I include AU on my Monthly Reporting Plan?
You’ll need to add AU to your Monthly Reporting Plan for every month you plan to submit AU data.
To add a new Monthly Reporting Plan, if one does not already exist, follow these steps:
- From the NHSN Homepage, select Reporting Plan from the left side menu.
- To add a new monthly reporting plan, click Add.
- Select the month and year for the AU data submission.
- Then scroll down to the Antimicrobial Use and Resistance Module section of the plan.
- Enter all the locations for which you’ll be submitting AU data that month and check the AU box (See screen shot below for reference).
- Click the Save button at the bottom of the screen.
To edit an existing Monthly Reporting Plan in the event that a plan already exists for that month, follow these steps:
- From the NHSN Homepage, select Reporting Plan from the left side menu.
- To find an existing new monthly reporting plan, click Find.
- Select the month and year for the AU data submission and click Find again.
- When the plan appears on your screen, scroll down to the bottom and click Edit.
- Once in edit mode, scroll down to the Antimicrobial Use and Resistance Module section of the plan.
- Enter all the locations for which you’ll be submitting AU data that month and check the AU box (See screen shot below for reference).
- Click the Save button at the bottom of the screen.
NOTE: You do not have to check the AR boxes unless you are also submitting AR Option data.
Q14: Is a monthly reporting plan required for AU reporting?
Yes, a monthly reporting plan is required, with AU reporting indicated, since AU data cannot be entered “off-plan”. See question #13 for how to set up a Monthly Reporting Plan.
- If an AU location ≠ FACWIDEIN, then it may be the only location in the AU section of the Monthly Reporting Plan for a month.
- If an AU location = FACWIDEIN, then it MUST have at least one other location added to the monthly plan
Note: Only data included in the CMS Quality Reporting Programs are shared with CMS. Just because data are checked on the monthly reporting plan does not mean it will automatically be shared with CMS. View the complete list of data required for each CMS Quality Reporting Program Cdc-pdf[PDF – 160 KB].
Q15: What locations do I use to report AU data?
NHSN strongly encourages the submission of data from all NHSN-defined inpatient locations, facility-wide inpatient (FacWideIN), and select outpatient acute-care settings (specifically, Emergency Department, Pediatric Emergency Department and 24-hour Observation Area) from which the numerator and denominator data can be accurately captured. If data from a given location are not able to be accurately electronically captured, data should not be submitted from that location. Additionally, that location’s data should not be included in the FacWideIN record.
Q16: Should my outpatient locations be included in my FacWideIN CDA file?
Only your facility’s inpatient locations (where patients are intended to stay overnight) with electronically captured numerator (antimicrobial days) and denominator (days present & admissions) data should be represented in the FacWideIN record. Outpatient locations such as the Emergency Department and 24-hour Observation Area should not be included in the FacWideIN record.
Q17: Should observation patients be counted in my FacWideIN CDA file?
All patients physically residing in an inpatient location should be included in the location-specific and FacWideIN data regardless of patient status (inpatient, outpatient, observation, etc.). Patients specifically housed in a location mapped as a 24-hour Observation Area are in an NHSN outpatient location and should not be included in FacWideIN.
Q18: Should I include the AU data from my inpatient rehab facility (IRF) with the rest of my AU data? It’s physically located in my hospital.
Yes, you can include IRF AU data as long as the unit is mapped as a location within the NHSN facility. Additionally, because the unit is mapped within that specific NHSN facility, it can be added to the AUR section of the monthly reporting plan regardless of whether the IRF has a separate CCN from the hospital. Further, the IRF location should be counted in the facility’s FacWideIN counts.
In the case where the IRF unit with the separate CCN is enrolled as a separate NHSN facility, those data would not be reported with the acute care hospital but instead within the separate NHSN facility. For example, AU data can still be accepted from an inpatient rehab facility or behavioral health facility that is enrolled in NHSN as its own facility using the rehabilitation hospital or psychiatric hospital designation. The submission process would be no different than a general acute care hospital.
Q19: Are topical administrations included in my AU data?
Topical administration is not a route that is included in NHSN AU data. The four routes accepted into the AU Option include intravenous (IV), intramuscular (IM), digestive, and respiratory. Any routes of administration outside of the four accepted routes are excluded from the AU Option reporting (for example, antibiotic locks, intraperitoneal, intraventricular, irrigation) and should not be included in either the total antimicrobial days or the sub-stratification of the routes of administration.
Q20: When counting antimicrobial days, if a patient receives two antimicrobials in one day, does that count as 1 or 2 antimicrobial days?
Each drug is considered separately for the NHSN AU Option. If a patient receives two separate drugs (for example, meropenem and amikacin) in the same calendar day that patient would attribute 1 total meropenem antimicrobial day and 1 total amikacin antimicrobial day to the location where they were housed at the time the antimicrobials were administered. The same logic would be used if the patient received IV meropenem and PO (digestive) amikacin.
However, if a patient was on a single drug (for example, ciprofloxacin) and given one dose in the morning via IV and another dose in the evening via PO, that patient would attribute 1 IV ciprofloxacin antimicrobial day and 1 PO ciprofloxacin antimicrobial day. But, since a single patient cannot contribute more than 1 antimicrobial day to overall the drug total in a single calendar day, that patient would only attribute 1 total ciprofloxacin antimicrobial day to the total for that given location.
Review Appendix C starting on page 17 of the AUR Module Protocol Cdc-pdf[PDF – 1 MB] for additional examples.
Q21: Patients in renal failure are only administered Vancomycin every other day but the drug persists in their system for 2 days. Does this count as 1 or 2 Vancomycin antimicrobial days?
This would count as 1 vancomycin antimicrobial day since, even in the setting of renal impairment, antimicrobials are only counted as an antimicrobial day on the day of administration.
Q22: Why does the total antimicrobial days in my FacWideIN record not equal the sum of all of my location records?
The sum of antimicrobial days for location-specific analyses would be higher than antimicrobial days for FacWideIN because multiple administrations of an antimicrobial in separate patient care locations within a single calendar day would account for multiple antimicrobial days for a given patient. For example, if a patient is administered Vancomycin in the Medical Ward and then transferred to the Medical ICU and receives another dose of vancomycin on the same day, this patient would contribute 1 vancomycin antimicrobial day to the Medical Ward, 1 vancomycin antimicrobial day to the Medical ICU but only 1 vancomycin antimicrobial day to FacWideIN.
Q23: When reviewing my AU line list, the sum of the routes does not equal total antimicrobial days for some drugs. Why is this?
The sum of the four routes for a given drug should at least be the same as or higher than the drug’s total antimicrobial days but never less than the total. In cases where the drug is administered more than once per day and is available via multiple routes, the sum of the routes can be greater than the total antimicrobial days for that given drug. However, keep in mind that the total antimicrobial days for a given antimicrobial should include only the counts administered using one of the four routes accepted into the AU Option (IV, IM, digestive, respiratory). Administration via any route other than the four accepted routes should be totally excluded from all AU Option data.
Check with your vendor to be sure only the four routes listed above are being included in the total antimicrobial days count.
Q24: Do partial administrations of an antimicrobial count as administered or do only completed administrations count?
Please only include completed administrations in the AU submission.
Q25: Is the days present denominator the same as the patient days denominator used in other parts of NHSN?
No. The days present denominator is not the same as patient days denominator. The definitions of each are listed below:
- Days present – number of patients who were present for any portion of each day in a specific patient care location
- Patient days – number of patients who were present in a specific patient care location during the once daily census count
For example, a patient admitted to the medical ward on Monday and discharged two days later on Wednesday will attribute 3 days present on that medical ward because the patient was in that specific location at some point during each of the three calendar days (specifically, Monday, Tuesday, and Wednesday). If this medical ward used midnight as the time of their daily census count, this same patient would only attribute 2 patient days since they were present for the census count at midnight on Monday and Tuesday only.
Please note, a patient can only be counted once for each location in a given day. Also, for a given location or FacWideIN, the days present count should almost always be higher than the patient day count since days present takes into account patient transfers and discharges.
Q26: If a patient is transferred from the Medical ICU to the Medical Ward in one calendar day, does that patient still only attribute one day present for FacWideIN?
Yes. A patient can only be counted once per calendar day for the FacWideIN record.
Q27: Should my days present be equal to my HAI patient days for a given location?
No. On average, for all NHSN AU Option reporting hospitals, AU days present are roughly 29% higher than HAI patient days for the same month/location in adult and pediatric ICUs and wards. On average, the AU days present for NICU locations are 14% higher than the HAI patient days for the same location. Take a closer look at your AU days present denominators to ensure they are being aggregated correctly as they do have the potential to influence your Standardized Antimicrobial Administration Ratio (SAAR) calculations. Additionally, we’d recommend validating your AU days present denominators using the methodology starting on page 10 outlined in the AU Option Implementation Data Validation protocol Cdc-pdf[PDF – 1 MB].
Q28: Can AU data be entered manually?
AU data can only be entered using CDA Import. Please review the “Uploading CDA Files into NHSN” Quick Learn video for additional details.
Q29: My vendor is asking me to provide my facility’s OID. What is an OID and where do I get one?
An OID is a unique identifier for your NHSN facility. It stands for Object Identifier (OID). Your facility may already have an OID. To verify if your facility has or needs an OID, navigate through the NHSN application as shown below.
If you’ve verified that your facility does not have an OID, follow the procedures for obtaining one outlined here: Object Identifier (OID) Entry Procedure Cdc-pdf[PDF – 30 KB].
Q30: Can we submit AU and AR CDA files together in the same CDA zip file?
Yes, but for manual upload all of the files in the zipped file must be from one facility. If submitting via DIRECT, the zipped file can contain CDA files for multiple facilities. The zipped CDA file can contain up to 1000 files or 2 MB zipped, whichever comes first. This includes both methods of transmission: manual and DIRECT CDA Automation. Please note, only alphanumeric, hyphen, and underscores are allowed in the CDA file names and zip file names, no special characters.
Q31: Do I need to include all 90 or 91 antimicrobials in my AU CDA file?
Yes. A newly added drug, delafloxacin, will be required to be included in CDA files containing AU data for January 2019 and later. This will increase the number of required drugs for the AU Option to 90. All 90 drugs are required to be included in the CDA file regardless of if they are used in the facility that month. A new optional drug, meropenem/vaborbactam, has been added for 2019. If meropenem/vaborbactam is included in the CDA file, the total number of drugs reported is 91.
Q32: How do I report antimicrobials not given if I have to include all 90 or 91 in my CDA file?
A value – a specific number, 0, or NA – must be reported for every antimicrobial listed in Appendix B of AU Protocol Cdc-pdf[PDF – 1 MB] regardless of whether the antimicrobial was used in the location/facility for a given month.
- Zero (0) – Use when the facility has the ability to electronically capture that antimicrobial (in the eMAR/BCMA) but did not administer it to any patients during the given month.
- Example: If Amoxicillin is used at the facility, but was not given to any patients during the month, the Amoxicillin count would be 0.
- This is expressed in the CDA file as value=”0″.
- Not applicable (NA) – Use when the antimicrobial can’t be electronically captured at the facility.
- Example: If amikacin is given via respiratory route to patients throughout the month, but cannot be captured by eMAR/BCMA, the amikacin count would be ‘NA’.
- This is expressed in the CDA file as nullFlavor=”NA”.
Q33: When I go to upload my files, I don’t see a specific option for uploading AU data. Please help!
In NHSN, after selecting Import/Export on the navigation bar, you should see the “AUR Summary Data” or “Events, Summary Data, Procedures Denominators” as an option to upload CDA files. If you do not see either of these options, your user rights need to be changed by a user with administrator-level rights. See the NHSN AU User Rights Cdc-pdf[PDF – 350 KB] document for more information.
Q34: How do I know if all of the CDA files I am submitting together in the same zip file were successfully uploaded into NHSN?
Sometimes when you are uploading multiple AU files together, some will successfully upload, and others will not. Here is a screenshot of what it looks like when you submit files together and you have some records pass and others fail. Note that both the Error Report and Submit buttons are enabled:
If you click on the Summary Data tab in the Validation Results table, you can see the files that passed validation and failed by looking in the Status column. In this instance, 2 records were submitted. One passed validation and one failed. When you click the Submit button, only the file that successfully passed validation will be uploaded. The PDF report generated after the Submit button is clicked will also show the file(s) that successfully imported and the files that did not pass NHSN validation and were not imported.
Q35: When I try to upload my AU data, I get an error message that says “Please upload files with .zip extensions only. Try again.” What does that mean?
CDA files are required to be uploaded in a zip file. Try zipping the file and resubmitting. Note that each zip file can contain one or many XML files.
Q36: When I try to upload my AU files, I get an error message that says, “Antimicrobial Use and Resistance Module not followed for this month, year, and location.” What does that mean and how do I fix it?
This error message means that the month, year and location in the CDA file you’re trying to upload is not selected in the Antimicrobial Use and Resistance portion of your Monthly Reporting Plan. Therefore, you’ll need to add the location(s) to the Antimicrobial Use and Resistance portion of your Monthly Reporting Plan for every month you plan to submit AU data. NHSN will not accept any data that is out of plan. To edit your monthly reporting plan to include AU, follow the steps in question #13. After you have edited your monthly reporting plan to include the AU data you are wanting to upload, NHSN should accept the CDA file for that month, year, and location.
If you have verified this location is on your monthly reporting plan, the error could be caused by incorrect location information in your CDA file. The CDA file uses the exact “Your Code” value as well as the “NHSN HL7 code” from the NHSN Location Manager. To see your NHSN location manager, select Facility in the left-hand navigation bar and then Locations and Find. We suggest you reach out to your vendor to verify the location information in NHSN matches the information in the CDA files you are uploading.
Q37: I found some errors in my AU data and I’ve fixed them with my vendor. How do I get the new data into NHSN?
If errors have been identified in the AU Option data, the specific location/month record can be addressed in two different ways:
- Manually delete and re-upload a new file (see question #10)
- Use succession management within vendor software to replace the old data with the new data
The location/month can be automatically updated within NHSN using succession management within your vendor software. Many vendors have implemented this feature by allowing users to simply export a new version of the file but be sure to work with your vendor to determine if this approach is appropriate for you.
Also, remember to regenerate your data sets within NHSN after uploading the revised CDA file in order to run analysis reports with the updated data. For more information on CDA succession management, see the FAQs on the NHSN CDA Submission Support Portal (CSSP).
Q38: How do I view my AU data once it’s been uploaded into NHSN?
AU Option data can only be viewed using the NHSN Analysis function. Specific details on AU Option analysis can be found in the NHSN AUR Module Protocol Cdc-pdf[PDF – 1 MB] or in the Analysis Resources section of the NHSN AUR Module web page.
Specific 2-3 page analysis quick reference guides have been developed to assist with viewing, modifying, and interpreting the AU Option data:
- Antimicrobial Use Line List Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use Rate Table – By Location Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use Rate Table – FacWideIN Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use Bar Chart Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use Bar Chart – Selected Drugs Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use Pie Chart Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use SAAR Table Cdc-pdf[PDF – 1 MB]
- Antimicrobial Use SAAR Table – By Location Cdc-pdf[PDF – 1 MB]
Remember to generate data sets within your NHSN facility before running your analysis reports so that any newly uploaded data will be included. See question #39 below for information on generating data sets.
Q39: I uploaded data for January but I don’t see it on the analysis reports. What happened to my data?
Newly uploaded data won’t appear in the analysis output options until a new data set is generated within NHSN. The data set is a snap shot of the data currently in your NHSN facility at the exact time you click the “Generate New Data Sets” button. You always want to generate new data sets after uploading data into NHSN. Also note that each NHSN user has their own data sets.
Q40: What is the SAAR and how is it calculated?
The Standardized Antimicrobial Administration Ratio (SAAR) is a metric developed by CDC to analyze and report antimicrobial use data in summary form. The SAAR is calculated by dividing observed antimicrobial use by predicted antimicrobial use. More information on how the SAAR is calculated can be found in the NHSN AUR Module Protocol Cdc-pdf[PDF – 1 MB]. Additionally, SAAR training videos can be found under Training here: NHSN AUR Training.
Q41: My facility has a SAAR over 1. Is that bad?
A high Standardized Antimicrobial Administration Ratio (SAAR) that achieves statistical significance may indicate excessive antibacterial use. A SAAR that is not statistically different from 1.0 indicates antibacterial use is equivalent to the referent population’s antibacterial use. A low SAAR that achieves statistical significance (specifically, different from 1.0) may indicate antibacterial under use. However, the SAAR alone is not a definitive measure of the appropriateness or judiciousness of antibacterial use, and any SAAR may warrant further investigation. For example, a SAAR above 1.0 that does not achieve statistical significance may be associated with meaningful excess of antimicrobial use and further investigation may be needed. Also, a SAAR that is statistically different from 1.0 does not mean that further investigation will be productive.
Q42: What locations are included in the 2017 baseline SAAR?
A 2017 baseline Standardized Antimicrobial Administration Ratio (SAAR) is only generated for locations mapped using one of the following CDC location types:
- Adult Medical Critical Care
- Adult Medical-Surgical Critical Care
- Adult Surgical Critical Care
- Adult Medical Ward
- Adult Medical-Surgical Ward
- Adult Surgical Ward
- Adult Oncology General Hematology-Oncology Ward
- Adult Stepdown Unit
- Pediatric Medical Critical Care
- Pediatric Medical-Surgical Critical Care
- Pediatric Medical Ward
- Pediatric Medical-Surgical Ward
- Pediatric Surgical Ward
At present, 2017 baseline SAARs are available to facilities that have submitted AU data from one of the 13 eligible adult and pediatric SAAR location types mapped in Table 5 of the NHSN AUR Protocol Cdc-pdf[PDF – 1 MB]. Future iterations of the SAAR can extend its use as a metric to additional patient care locations when aggregate data are sufficient for those purposes.
Q43: Can I generate a SAAR report for one location and for one month?
A Standardized Antimicrobial Administration Ratio (SAAR) can be produced by month, quarter, half year, year, or cumulative time periods. The SAAR report can be generated to show SAARs by a specific location or a subset of location types. NHSN is able to generate SAARs for data submitted into locations mapped using one of the 13 CDC location types specified in question #42. While we encourage facilities to submit AU data from all inpatient locations, the only locations that can generate SAARs are those mapped to the 13 CDC locations listed above. In the future, as more facilities continue to submit AU data we hope to have enough data to develop SAARs for additional location types. To generate a SAAR by location and month, follow the steps in the SAAR Table—by location Quick Reference Guide. Cdc-pdf[PDF – 650 KB]
Q44: I’m not submitting data into the AU Option but I’d like to compare my antimicrobial use against other facilities using the SAAR. Is this possible?
At this time, the Standardized Antimicrobial Ratio (SAAR) is only available within NHSN for facilities reporting into the AU Option. A SAAR paper has been published to describe the 2014 methodology. Additional 2014 baseline SAAR model details can be found here:
van Santen KL, Edwards JR, Webb AK, et al. The Standardized Antimicrobial Administration Ratio: A new metric for measuring and comparing antibiotic use. CID 2018; 67:179-85.
We plan to publish the 2017 methodology at a later time. Keep in mind, facilities not participating in the NHSN AU Option would still be required to accurately capture the AU Option-defined antimicrobial days and days present in order to calculate their own SAAR outside of NHSN.