Making use of electronic data: the National Healthcare Safety Network eSurveillance Initiative.

Efforts are underway at the Centers for Disease Control and Prevention to foster greater use of electronic data stored in health care application databases for surveillance of health care-associated infections and antimicrobial use and resistance. These efforts, referred to as the National Healthcare Safety Network (NHSN) eSurveillance Initiative, focus on standards-based solutions for conveying health care data and validation processes to confirm that the data received at the Centers for Disease Control and Prevention accurately reflect the data transmitted by health care facilities. Standard vehicles for data transmission, specifically Health Level Seven standards for electronic messages and structured documents, and standard vocabularies for representing microorganisms and other information needed for surveillance, are central features of the eSurveillance Initiative. Progress to date in this initiative is reviewed, and future project plans are outlined. Enhanced interoperability between health care and public health information systems is achievable for surveillance purposes, but major challenges must be overcome to realize the full benefits sought by the eSurveillance Initiative.

Dialysis Surveillance Report: National Healthcare Safety Network (NHSN)-data summary for 2006.

Thirty-two outpatient hemodialysis providers in the United States voluntarily reported 3699 adverse events to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) during 2006. These providers were previously enrolled in the Dialysis Surveillance Network. The pooled mean rates of hospitalization among patients with arteriovenous fistulas, grafts, permanent and temporary central venous catheters were 7.7, 9.2, 15.7, and 34.7 per 100 patient-months, respectively. For bloodstream infection the pooled mean rates were 0.5, 0.9, 4.2, and 27.1 per 100 patient-months in these groups. Among the 599 isolates reported, 461 (77%) represented access-associated blood stream infections in patients with central lines, and 138 (23%) were in patients with fistulas or grafts. The microorganisms most frequently identified were common skin contaminants (e.g., coagulase-negative staphylococci). In 2007, enrollment in NHSN opened to all providers of outpatient hemodialysis. Specific information is available at http://www.cdc.gov/ncidod/dhqp/nhsn_FAQenrollment.html.