Facility name for California general acute care hospitals reporting to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) in calendar year 2020.

California general acute care hospitals are categorized into four major categories consistent with the categories NHSN uses for risk adjustment: 1) Acute Care Hospital, 2) Long-Term Acute Care Hospital, 3) Critical Access Hospital, and 4) Rehabilitation Hospital or Unit

Specific types of California hospitals are Major Teaching; Pediatric; Community, >250 Beds; Community, 125-250 Beds; Community, <125 Beds; Long-Term Acute Care (LTAC); Critical Access; Free-Standing Rehabilitation; and Rehabilitation Unit. A major teaching hospital is a hospital that has a teaching program for medical students and a post-graduate medical training program. A pediatric hospital is a hospital with inpatients predominantly age 18 years or younger. A community hospital is a CDPH designation for hospitals not classified as major teaching, long-term acute care (LTAC), critical access, pediatric, or rehabilitation. Community hospitals are further categorized by number of active beds as reported by the hospital in the NHSN Annual Survey. A LTAC hospital is defined by the Centers for Medicare & Medicaid Services (CMS) as a licensed general acute care hospital providing care for patients with medically complex conditions requiring an average length of stay greater than 25 days. A critical access hospital is designated by CMS as a hospital with 25 or fewer acute care inpatient beds, located more than 35 miles from another hospital (with some exceptions), with an average length of stay of four days or less. A rehabilitation hospital is an acute care facility exclusively providing evaluation and restoration of function for patients who have lost function due to acute or chronic pain, musculoskeletal problems, stroke, or catastrophic events resulting in complete or partial paralysis. A rehabilitation unit is an inpatient ward within a general acute care hospital providing evaluation and restoration of function for patients who have lost function due to acute or chronic pain, musculoskeletal problems, stroke, or catastrophic events resulting in complete or partial paralysis. A rehabilitation unit typically has its own unique CMS certification number (CCN) and reports separately from the rest of the hospital.

Number of reported CLABSIs. A rehabilitation unit with its own CCN number reports separately from the rest of the hospital. The "NHSN Patient Safety Component Manual" document contains the specific criteria for CLABSI surveillance and reporting and provides examples of how to apply the CLABSI definition. See the NHSN website: http://www.cdc.gov/nhsn.

The predicted number of CLABSI as determined by the 2015 national baseline data, adjusting for significant risk factors and based on the number of central line days reported by the hospital. See the Guide to the SIR at the NHSN website: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf.

The number of patients with central lines counted at the same time each day. At the end of the month, the daily counts are summed and entered into NHSN. Central line data from electronic databases may be used as long as the counts are not substantially different (+/- 5%) from manually-collected counts, validated for a minimum of 3 months. See the NHSN website: http://www.cdc.gov/nhsn.

The standardized infection ratio (SIR) is a summary measure used to track HAIs over time. The SIR compares the number of reported CLABSIs to the number of predicted (expected) number of CLABSIs, based on national baseline data. The SIR also adjusts for several factors that may impact the risk of acquiring a CLABSI. Hospitals with NHSN-predicted number of CLABSI <1 had no SIRs calculated by NHSN. An SIR was calculated by CDPH if the predicted number of infections was =0.2. The SIR and its comparison are not as accurate as SIRs based on a larger number of predicted infections. NOTE: See the NHSN Guide to the SIR: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf.

Lower limit of the SIR 95% confidence interval calculated using exact Poisson distribution. The confidence interval quantifies the precision of the calculated SIR that is associated with random variation. NOTE: If the 95% CI for the SIR includes 1, the number of reported infections is not statistically different from that predicted.

Upper limit of the SIR 95% confidence interval calculated using exact Poisson distribution. The confidence interval quantifies the precision of the calculated SIR that is associated with random variation. NOTE: If the 95% CI for the SIR includes 1, the number of reported infections is not statistically different from that predicted.

The calculated SIR 95% confidence interval indicates if the observed number of infections was significantly different from the predicted number of infections. Based on the SIR 95% confidence interval, we labeled each SIR as indicating: 'Better' (fewer observed infections than predicted), 'Same' (no significant difference in the number of observed and predicted infections), 'Worse' (more observed infections than predicted).' This field is blank if SIRs the predicted number of infections was <0.2.

Central Line Insertion Practices (CLIP) data are presented as the percentage of CLIP observations in a hospital critical care locations with adherance to all eight components of the CLIP bundle. The CLIP adherence measure is computed as the total number of adherent insertions divided by the total number of CLIP observations.

California hospitals are required to report data throughout each calendar year on a quarterly basis. NHSN data are downloaded in monthly units. This field indicates the number of months for which a hospital reported "complete" data, defined as a numerator (CLABSI cases or zero CLABSI) and a denominator (central line days).

A hospital labeled "Incomplete Reporter" is a hospital reporting CLABSI data for fewer months than it was operational.

¥ SIR was calculated by CDPH if the predicted number of infections was =0.2. The SIR and its comparison are not as precise as SIRs based on a larger number of predicted infections.