2008 to present
Mode of Collection
Surveillance data: passive data collection.
The National Healthcare Safety Network (NHSN) is a secure, internet-based surveillance system that integrates patient and healthcare personnel safety surveillance systems managed by the Centers for Disease Control and Prevention Division of Healthcare Quality Promotion (CDC, DHQP). NHSN is the nation's most widely used healthcare-associated infection (HAI) tracking system. It provides facilities, states, regions, and the nation with data needed to identify problem areas, measure progress of prevention efforts, and ultimately eliminate HAIs. NHSN allows healthcare facilities to track antibiotic resistant (AR) organisms, antibiotic use, and other adverse events (e.g., blood safety). NHSN is also being used by hospitals and nursing homes to track and report the novel coronavirus (COVID-19) in their facilities, as well as provide indicators of facilities' capacity to meet surges in demand from COVID-19. NHSN fulfills the Centers for Medicare and Medicaid Services (CMS) and state requirements for HAI-AR reporting, and CMS nursing home COVID-19 reporting requirements. CMS also uses CDC's NHSN data and publishes it on the CMS Hospital Compare and Nursing Home compare websites.
NHSN is the nation's most widely used HAI tracking system, collecting data from over 37,000 healthcare facilities in the 50 states, DC, Puerto Rico, US Virginia Islands, American Samoa, Guam, and the Northern Mariana Islands. All American healthcare facilities are eligible for enrollment in NHSN: acute care (including Veterans Affairs and Department of Defense medical centers), long-term acute care hospitals, psychiatric hospitals, and rehabilitation hospitals, outpatient dialysis centers, ambulatory surgery centers, and long-term care facilities and nursing homes. NHSN compiles HAI data reported from over 6,000 hospitals nationwide to compute national acute-care hospital-onset infection measures. Additionally, CDC augmented NHSN to meet the immediate needs of the COVID-19 pandemic. Approximately 3,500 hospitals and almost all 15,400 CMS-certified nursing homes report COVID-19 case and facility capacity data to NHSN.
All U.S. healthcare facilities are eligible for enrollment in NHSN including acute-care hospitals, long-term acute care hospitals, psychiatric hospitals, rehabilitation hospitals, outpatient dialysis centers, ambulatory surgery centers, and long-term care facilities and nursing homes. Facilities report relevant information within NHSN for infections and other adverse events per NHSN criteria and definitions. The criteria used are dependent on the event being reported. Facilities can report data electronically via Clinical Document Architecture (CDA) standard data import or can manually enter data in the appropriate online form within NHSN. Data reports are compiled within the system for use by CDC, healthcare facilities, and other users for analysis. For NHSN's Antibiotic Use and Resistance (AUR) Module, all reporting is electronic. CDC provides these data to CMS to help carry out quality improvement initiatives as well as to fulfill reimbursement and facility reporting requirements.
Response Rates and Sample Size
Response rates for data submission are high as hospitals and dialysis units must report data to qualify for certain types of reimbursement. In addition, facilities (e.g., long-term care facilities) are required to report this type of data in NHSN as part of CMS' quality improvement initiatives. Over 99% of hospitals (approximately 6,870 facilities) use NHSN to report HAI and AUR data; 60% of hospitals use NHSN to report COVID-19 data; and over 99% of nursing homes (more than 15,000) use NHSN to report COVID-19 data.
NHSN criteria and definitions are regularly updated to incorporate advances in infection detection and prevention. CDC's last major update was in 2020.