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1 Please stand by for realtime captions. [Captioner is on hold, waiting for event to begin.] >> Welcome to today's webinar, understanding your National Healthcare Safety Network Clostridium Difficile data, today will be recorded if you need to mute yourself, if you can please mute your phone, that would be lovely. Thank you so much. >> My name is Kristin Ives, IM with Telligen, quality improvement network, for Colorado Iowa and Illinois, we will have time for questions at the end, if you have any questions put them in the chat function, to the right of the screen, Sarah will be checking those, today's slides will be sent out to all participants after the presentation, they will have screenshots of the live demo that we will do. I will go ahead and show you the database, which I'm sure you are all familiar with, I will show you quickly a quick reminder. The first reminder. The agreement to participate in consent, if you have this paragraph that I am highlighting here in bold text, if you login, go ahead make sure that you click here. A little link will say click here, it will pull up a PDF document, when you scroll back to the very bottom, this is an area that will have your name is a contact. When you scroll to the very far right, there is a chai -- Tiny checkbox. You press submit. >> If you get an about the re-consent being do still, also I know NHSN sent this out last week, that is where you find it. >> I want to give another reminder, if you have this action items survey required 2017, go ahead and get that document completed. If you need the paper for that version, we can get that to you before you go into the database to complete it. Now we will show you how to get to your data, you have been entering 10+ months, 14 months now. You probably want to know how you can get the data back out. >> I am going to go into a test environment, it will look just like you would have when you log into your facility. The first thing go to the left hand navigation, I call it the blue navigation panel at the left side, there are two options. You will go into generate data set first. What this is, when you generate your data set, you will be pulling current data, basically it will take a snapshot of all the data you have entered, if you don't generate data sets before you pull your reports, you may not include the most recent data you entered. It is always a good idea to generate your data sets before you pull any report, it will make sure that everything recent is included. >> When you go to this, click on generate new blood -- Click on generate new, button. -- This may take a moment. >> While we are waiting for this. I will ask Sarah, if she has any questions and chat? Or if you have anything else to add? >> Thanks Kristin, this is Sarah. There are no questions in chat right now, if you do have a question please feel free to type it in, or you can press pound six to unmute. I just want to remind everyone of our Telligen nursing home website, I just put in chat, we recently updated our toolkits, there is a lot of great resources, pressor ulcers, dementia, all sorts of ones, click on the homepage. The link I put inch -- Into chat you will see the overview.

2 >> Thank you Sarah. >> As you will see on the screen, it will give you an alert that says data sets were successfully generated. You can click on okay. Go back to the blue navigation panel, go to analysis. And this time reports. When you click on reports it will pull up collapsed folders. As you can see there are several of them poke around any of these reports to see what might be useful to you, you can play with them, it doesn't hurt or change anything. I will show you really click a report that will be helpful to you, in the advanced folder. When you click on advanced, it expands a month of subfolders. We will actually go to facility level data. When you click on facility level data, it expands it again, there is a report called line listing annual survey of nursing home elements. When you click on this. There are options to run report, modify report and export data, we will just run report. Run report I think of as a temporary way, or a quick way to look at the data. I will do one run report, the little window will pop up that summarizes the data for you, what this is, this report shows you CDC core elements for antibiotic stewardship for nursing homes, there are severance -- Several elements. >> It will show you how many core elements have been met. You can see this Test Facility in 2016, there has been met all 27. This can track your facility progress, it will pull the data from the annual surveys. When you complete the annual survey of the previous year, it will automatically calculate how many of these things have been met. I want to show you that additional report. Now we will look at your specific C. diff. data. The folder we will look at is the CDI module LAV -- The lab ID. >> We will expand for that folder. >> We will click on it expanded. >> We will go to line lifting -- Listings -- The three listings will repair -- Appear. I will choose export data set. I find this is the easiest way to look at your data. You can export in an Excel file, I will show you in a moment. It will be easy for you to modify, add, delete, etc. I will export data set. Now it will ask me what format would you like to export in? I ask for Excel spreadsheet, most common one everybody has Excel, I always change it to the Excel spreadsheet, and then export. It might take a moment, while we are checking for that, I want to check with you to see if there are any questions and chat? >> No questions in chat, feel free to type when in or unmute your line by pressing pound six. >> Okay, when it exports, this little pop-up will appear at the bottom. It will say do you want to save the file or open it. I save it to my desktop, or somewhere I can find later, save, then save as, I have already downloaded these reports. I will show you them now. It will download with a lot of extra columns. As you can see some of these columns are blank. OID, then these custom arose, these are all blank -- These are all custom Rows, and they are all blank. I sort by event date. I will make it a little bigger, when it exports, it does not export in chronological order, I always take out the X here, the extra columns which is the easiest way to look at it. I have removed all the MT columns, and sorted by event date. >> Now I will go through the pertinent columns on this report so that you know what they mean. The very first one I will talk about here, antibiotic prescription. As you can see. It says N and a lot of them

3 some of them are blank, this is when they were prescribed antibiotics for C. diff. when they were admitted, nothing for pneumonia, it was just about C. diff. where they on an antibiotic when they came in. That is what the column is for. As you scroll over, you will see general data about the person, it will have their gender and their name, locations are listed here. These are helpful. Just so you know where the person was when it happened. You can look at it and say, a lot of these are happening in the same area of the facilities, are they sharing staff? Are they possibly places that are not cleaned as good? Do they have a higher acuity? It is a good thing to look at these things where they're happening and see if you discover a pattern. This is previous positive, this is self explanatory, whether that resident has had any previous positives for C. diff., yes or no. >> As you scroll over, it will show resident type, short stay or long stay. That is usually a cut off of 100 days. 100 days or less. Long stay is 100 days or longer. It will show your service type. Depending on what you had input before, there is dementia, skilled nursing, general nursing, some of the facilities that we work with have these patients as well, hospice, service type it will show. As you scroll over further, it will show you your event date. >> Sometimes I start on this column it is really important to look at your event date. There are a lot of events happening in a month, you can see there were a lot of events in March And then it goes back down one or two per month, then another burst in June. It is good to look at patterns to see whether you are having a lot of C. diff. in a given month or not. It is helpful to see the actual numbers, sometimes you put the data in, and something is happening you can cure -- Can't quite remember, it's a good way to start looking at your data. >> I want to go into admit event days, this is interesting. This is when the event occurred, how many days where they in your facility from admission to event. As you can see this Test Facility is all over the board. This tells you whether someone has been in your facility for a long time before they got C. diff., or likely came in with a, or something shortly after you have admitted them to your facility. >> In addition to that NHSN categorizes to your event based on this emission to event day. -- Admission to event day -- It is the long-term event column, LO, stands for long-term care facility onset, over four weeks. These are attributed basically to your facility, having acquired them, the next one is ACTLO, acute care transfer facility, this means they were transferred from an acute care facility, when you go down to CO, community onset, they were receiving three or less days before they had their last event. You can see at the bottom, there is one that says three, one, these are people that pretty much came in with that, community required, NHSN attributes these based on the admit to event day. >> I know I breezed through that quickly. I wanted to see if anybody has any questions? >> Either in chat or on the phone, you can press pound six to unmute yourself if you have any questions about the spreadsheet download, I would love to answer any questions that you may have. >> Sarah do you have any questions and chat? >> There are no questions and chat at this time. Okay.

4 >> Okay I do have a question. >> It's Victoria. With the other column you are talking about the antibiotic, I just wanted to know if the antibiotic was specifically prescribed? Are they keeping track on who is on antibiotics, it doesn't mean that the C. diff. doesn't occur they were on the antibiotics for something else? Are they keeping track on that? >> I don't believe that is a question that they ask is this person on antibiotics for something else? You can see these people who have very short to admit days, you can say that these people, where did they come from, are they coming from the same facility? Is it a facility to tends to prescribe antibiotics, do we need to reassess whether these antibiotics are still warranted? You can really do a timeout for those. It is a good thing to do on your own. This data is helpful to go back and examine that to find the patterns that you are suggesting. I know it happens a lot. People come in on all sorts of antibiotics, within the house, you have a Doc that puts him on [Indiscernible - low volume], and then they acquire C. diff., it's just a good way to look and monitor these people. >> Thank you. >> Do we have any other questions? >> Yes a question in chat, Laura lie asks if we input this information that is in the column, she is a little bit new and she is still learning? >> Wonderful yes, what this does, this report is pulled out of NHSN, these are just events, it is not the summary data, admissions, not that, in this is whether you have events, positive C. diff. test, when you enter a positive resident, it will ask you these questions, based on these questions, this is what it will pull out this data, from the questions that you ask. Did that answer your question Lauralie. >> Does anyone else have any questions? >> Thank you that answered her question. >> Hello Kristin this is Deanna from Telligen, I want to add to your very good answer to antibiotics yes or no. On the left side of the spreadsheet. We know CDC has some optional fields, that is one of those optional fields it can be used by the facility for them to track how many residents are coming in on animatics for C. diff., next to it is the comments, optional field, we have seen facilities use that comment section efficiently. For example if the person is coming in with a big wound, or pneumonia, and they are on multiple antibiotics they may put a note in that field, that really helps when they go back to analyze the data to know the person was really sick and on a lot of antibiotics may have contributed to them acquiring C. diff., I just wanted to answer that a little bit more. Some of this is just for you guys, the information is just for you to use, it is not anything CDC is using itself. The ones required are the ones that CDC is an compiling and using. Thank you Kristen, -- Great question. >> Thank you for chiming in.

5 >> Do we have any questions about the spreadsheet I know is a bit of a monster. As I mentioned at the beginning. The slides for today. They will have screenshots of how you do this. If I went through it too fast, or you missed the beginning part, the slides I will send out to you guys, will have screenshots on how to get the data and pull this report. It will have a couple of ideas on analysis as well. If you feel you have missed something that should help you with it. >> Also I wanted to give a quick plug here, for our weekly digest that we have Turco if you haven't subscribed already -- for our weekly digest. If you haven't subscribed yet already, I want to let you know for the newsletter you get every Monday, click on this link and you can sign up to receive it. I wanted to also mention we are here to help you. With anything that is NHSN related, mostly me and Sarah, anything with your antibiotic stewardship, loading improvements, as you can see we have a lot of staff who can give you resources. Tips, and also technical assistance. Any other questions? >> Kristin it's Deanna again, I would just be anxious and interested whether they are using this data or have used it, I know this is very useful for their surveillance, and also about the stewardship program, I'm just interested if you guys can chat in if you're using are not, we want you to see the value in this great information that you are compiling and putting into NHSN every month. >> Thank you Deanna. >> This is NHSN -- [Indiscernible - low volume] with Medicare, -- I will be using this with my meeting. >> Yes. >> Absolutely. >> I will print this up for you, Victoria Allison, I have not previously pulled the spreadsheet before, this is the first time I learned how to do it, I am excited to do it I have seen a couple of things in chat. I know for some of you, your numbers are low in C. diff., but it is still helpful if you would like to learn how to pull the report it's helpful. >> I also want to let you know, very soon. Within the next week or so, we will be getting the baseline data from CDC, the reason why you have been doing this, the CDC wanted a baseline for nursing homes, and they are ready to release what that baseline is, once we get that data, and have it prepared. We will send that out to you guys, it is very exciting. >> Are there any other comments or questions? Okay. When you exit today's webinar. There will be a survey for feedback. We would love for you to complete that. We are always trying to improve the events for you. Let us know if there is anything you would like to see. Thank you for joining today. If you have any other questions. I will stand malign for the next few minutes. Otherwise that concludes today's presentation, thank you for joining. >> [Event Concluded]