Category: Professional Posters
Purpose: Antimicrobial resistance is a major concern facing healthcare. The National Healthcare Safety Network (NHSN), from CDC, is a free database for hospitals to use for surveillance and submission of their antimicrobial use and resistance (AUR) data. Submission of AUR data is an option to attest to CMS Meaningful Use Stage 3, however, upload of AUR data to NHSN has been difficult. Through a cooperative agreement from CDC, funding was available to create an electronic integrated system to automate the pull and upload of AUR data from hospitals to NHSN.
Methods: The Epidemiology and Laboratory Capacity Cooperative Agreement from CDC provides funding to the Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Program at the Kansas Department of Health and Environment for antimicrobial stewardship efforts in the state. Using these funds, the HAI/AR Program had a cloud-based integration platform developed that can directly connect to a hospital’s electronic health record (EHR) system. This platform automatically pulls AUR data and submits data to NHSN. This is done in three steps. First data is acquired, either by receiving it as part of the data feeds provided by the hospital or by querying the system for the required elements. Next, the data is aggregated and consolidated into one dataset. Mapping and logic are applied so only the data needed for the AUR modules will be sent in the required CDA format. Finally, the dataset is transmitted to the AUR modules. Once this integration is built for a particular EHR system, any hospital in KS using that EHR will be able to utilize it if desired. Use of this integration platform will give the facility and the HAI/AR Program access to their AUR data. This can help target stewardship efforts and evaluate effectiveness of implemented interventions. The HAI/AR Program has a goal to recruit KS hospitals using NHSN to participate in this project we have called the KS Antimicrobial Stewardship Initiative (ASI).
Results: One hospital in Kansas served as the pilot site for the ASI project. The following data elements were requested to be submitted to the NHSN AUR modules: susceptibility, specimen source, pathogen name, location of the patient and visit, patient ID, antimicrobial ordered, and route of administration. The integration was successful and NHSN continues to receive data from the pilot hospital. This was a much faster and less expensive method than has previously been reported by facilities who have begun uploading data to NHSN AUR modules through their EHR vendors. Data extracted can be aggregated to provide meaningful reports to clinicians to support their antimicrobial stewardship program (ASP). Days of therapy and dose per day as well as dispensing units and prescribers can be reported out of the NHSN dataset. Antimicrobial class, redundancy in therapy, de-escalation, and escalation are necessary data points for the hospital to evaluate opportunities for education and ASP improvement. Reports such as these are available through participation in the ASI.
Conclusion: Antimicrobial resistance is a major contributor to longer hospital stays, multiple readmissions, and patient deaths. The NHSN AUR module allows for aggregation and centralization of data from hospitals. A cloud-based integration platform can successfully be used to query a facility’s EHR for required data, and to transmit the data to NHSN daily. Data transmitted can be used by the hospital to guide and evaluate the efforts of their ASP. The HAI/AR Program will aggregate this data to evaluate antimicrobial resistance and usage patterns throughout the state allowing for a more targeted approach in assisting and guiding antimicrobial stewardship in KS.