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NHSN reporting requirements: Everything you need to know for 2022

Due to the onset of the COVID-19 pandemic in early 2020, the National Healthcare Safety Network (NHSN), a comprehensive, healthcare-associated infection (HAI) tracking system, updated some of the existing NHSN reporting requirements and implemented some new ones as well.

Facilities that collect and submit data to the NHSN include:1

  • Acute care hospitals
  • Rehabilitation hospitals
  • Ambulatory surgery centers
  • Nursing homes

Routinely, organizations collect HAI data and submit it to this secure, internet-based surveillance system.

According to the Centers for Disease Control and Prevention (CDC), while about 300 hospitals used this system at the start, it now serves more than 37,000 U.S. healthcare facilities that track data to help make improvements.2

But the pandemic upended the normal situation.

In a constantly shifting healthcare landscape, healthcare providers need to take a step back and become familiar with the most current reporting guidelines and requirements.

The National Healthcare Safety Network & HAIs

To help organizations in their efforts to identify HAIs and develop effective strategies for reducing them, the National Healthcare Safety Network collects data on the following:

  • Central line-associated bloodstream infections (CLABSIs)
  • Catheter-associated urinary tract infections (CAUTIs)
  • Ventilator-associated events (VAEs)
  • Surgical site infections (SSIs)
  • Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream events
  • Clostridioides difficile (C. difficile or C. diff) events

The NHSN's 2019 National and State Healthcare-Associated Infection Progress Report stated that organizations were making progress in decreasing some HAIs' prevalence. The report described a 7% decrease in CLABSIs between 2018 and 2019 and an 8% decrease in CAUTIs.3

Then COVID-19 arrived on the scene, posing an enormous infectious disease challenge. The NHSN COVID reporting era was about to begin.

NHSN COVID-19 reporting takes center stage

In 2020, the National and State Healthcare-Associated Infections Progress Report stated the world experienced unprecedented challenges due to the pandemic, which impacted the surveillance and incidence of HAIs.4

Hospitals also experienced higher-than-usual hospitalizations and shortages in healthcare personnel and equipment — which may have resulted in decreased surveillance activities and reporting via the NHSN.4

As healthcare organizations shifted resources to fight COVID-19, other infection control efforts paid the price:4

  • CLABSI infections in acute care hospitals increased by 24% between 2019 and 2020
  • Hospital-onset MRSA bacteremia increased by 15%
  • VAEs increased by 35%

One bright spot (among a few): C. diff infections in acute care hospitals declined by 11%. Furthermore, not all facilities were reporting data during that time.

COVID-19 temporarily alters NHSN reporting requirements

In response to COVID-19, the Centers for Medicare & Medicaid Services (CMS) implemented its extraordinary circumstances policy (ECE) to exempt many healthcare facilities from specific reporting requirements, including HAI surveillance and reporting data from Q4 2019 through Q2 2020.

Though many acute care hospitals did continue to report data for many HAIs during the first two quarters of 2020, there were notable drops in the number of hospitals reporting data for VAEs and SSIs.

To put it simply, the NHSN gave a reprieve when it comes to NHSN reporting in the thick of COVID-19.

Getting up to speed on NHSN & CDC changes

Staying abreast of changes to HAI reporting requirements is vital in 2022 because organizations have some catching up to do. It does, however, add to an already-heavy regulatory burden on physicians and executives.

In fact, a 2021 Medical Group Management Association (MGMA) report noted that medical practices are facing "overwhelming regulatory challenges" that increase every year, with 91% of physicians reporting that the regulatory burden on their medical practice increased over the prior 12 months.5

You can stay informed of changes and updates from the NHSN and CDC by consulting the NHSN Patient Safety Component Manual.6 Each year, the CDC weighs feedback from experts and publishes an updated version of the manual — with the most recent update posted in early January 2022.

The latest NHSN reporting requirements

The latest update does not contain any significant changes to the following chapters:

  • Identifying HAIs in NHSN
  • Monthly reporting plan
  • Bloodstream infection
  • Central line insertion practices (CLIP)
  • Urinary tract infections
  • Locations

The manual does include clarifications and/or updates for the following topics:

  • Pneumonia | Including the definition for VAE and guidance for determining eligible imaging test evidence
  • Surgical site infection events | The definition for a surveillance period and clarifications of NHSN operative procedures and SSI event reporting instructions
  • VAEs | A clarification for pleural fluid specimens
  • Pediatric ventilator-associated events (PedVAE) | Updates to electronic counts guidance
  • Multidrug-resistant organisms (MDROs) and clinical documentation improvement (CDI) | New graphics but no content changes
  • Antimicrobial use and resistance | Updates to aortic regurgitation (AR) event congenital dyserythropoietic anemia (CDA), the AR option and the AR option phenotype definitions
  • Key terms | New definitions for non-bedded location and SSI surveillance period and clarifications for device-associated infections
  • Surveillance definitions

Although it may seem daunting, start your research by checking the update summaries and reviewing the changes or clarifications you may need to become more familiar with.

Need more information? Follow up with an in-depth study of the 2022 NHSN Patient Safety Component Manual to learn the specifics of all updates and clarifications. You may find your HAI data is up to date and ready for new developments before you know it.


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