Table 1a. Characteristics of facilities reporting to NHSN by State ¹, 2010: Central Line-associated Bloodstream Infections (CLABSI)²

State	No. of Facilities in State ³	2009									2010
		No. of Facilities Covered by Mandate⁴	Any Validation⁵	Healthcare Facilities Reporting to NHSN							No. of Facilities Covered by Mandate⁴	Any Validation⁵	Healthcare Facilities Reporting to NHSN
				No.	%⁶	Data Submission %⁷	Locations (n)²						No.	% ⁶	Data Submission %⁷	Locations (n)²
				No.	%⁶	Data Submission %⁷	Total	ICU	Wards²	NICU⁸			No.	% ⁶	Data Submission %⁷	Total	ICU	Wards²	NICU²
Alabama	122	0		1-4	<10.0	67.3	27	12	11	4	0		69	56.6	45.8	157	112	38	7
Alaska	29	0		1-4	<10.0	55.6	3	2	0	1	0		1-4	<20.0	81.3	4	3	0	1
Arizona	105	0		1-4	<10.0	100.0	4	4	0	0	0		24	22.9	63.7	53	42	10	1
Arkansas	105	0		6	5.7	59.6	20	12	7	1	0		22	21.0	52.2	42	29	9	4
California	383	0		139	36.3	73.1	461	220	206	35	M		367	95.8	74.0	2,239	546	1,567	126
Colorado	100	59	Yes	60	60.0	91.4	97	63	17	17	58	Yes^a	60	60.0	82.2	10	64	26	17
Connecticut	42	30	Yes^a	30	71.4	97.9	39	38	0	1	30	Yes^a	30	71.4	91.5	41	38	0	3
Delaware	14	8	Yes	8	57.1	79.6	18	13	3	2	8	Yes	8	57.1	85.5	19	13	4	2
D.C.	16	0		1-4	<30.0	90.6	8	8	0	0	M	Yes	11	68.8	42.6	36	24	7	5
Florida	213	0		21	9.9	75.1	57	37	15	5	0	Yes	51	23.9	53.2	168	81	78	9
Georgia	172	0		16	9.3	78.4	69	40	23	6	0		37	21.5	67.4	154	67	76	11
Hawaii	28	0		1-4	<10.0	75.0	1	1	0	0	0		7	25.0	45.1	12	6	6	0
Idaho	52	0		1-4	<10.0	100.0	1	1	0	0	0		1-4	<10.0	40.3	6	2	3	1
Illinois	215	150	Yes	148	68.8	80.2	325	228	66	31	149	Yes^a	148	68.8	87.4	349	227	84	38
Indiana	147	0		1-4	<10.0	75.5	18	9	7	2	0		34	23.1	51.1	95	48	41	6
Iowa	121	0		1-4	<10.0	70.2	7	5	2	0	0		25	20.7	40.4	39	28	9	2
Kansas	156	0		7	4.5	79.3	25	17	6	2	0		17	10.9	70.3	41	25	13	3
Kentucky	124	0		13	10.5	75.8	54	34	17	3	0		21	16.9	70.3	67	45	18	4
Louisiana	228*	0		10	4.4	85.0	56	19	32	5	0		31	13.6	52.5	93	43	40	10
Maine	36	0		1-4	<20.0	79.6	27	10	16	1	0		7	19.4	76.9	30	12	17	1
Maryland	70	45	Yes^a	48	68.6	97.1	114	83	15	16	45	Yes^a	47	67.1	81.1	143	85	41	17
Massachusetts	111*	73	Yes^a	72	64.9	93.6	157	129	18	10	73	Yes^a	71	64.0	95.1	151	123	18	10
Michigan	190	0		32	16.8	80.4	102	72	23	7	0		52	27.4	67.6	159	100	50	9
Minnesota	141	0		1-4	<10.0	43.8	4	4	0	0	0		1-4	<10.0	61.9	7	6	1	0
Mississippi	106	0		6	5.7	89.7	47	17	28	2	0		16	15.1	76.5	78	27	45	6
Missouri	156	0		8	5.1	90.6	16	12	2	2	0		13	8.3	90.5	28	18	6	4
Montana	61	0		5	8.2	92.9	7	5	1	1	0		10	16.4	73.1	30	11	16	3
Nebraska	92	0		1-4	<10.0	95.8	20	5	14	1	0		10	10.9	66.2	35	11	22	2
Nevada	59	0		1-4	<10.0	63.5	8	6	1	1	M		23	39.0	36.4	69	33	33	3
New Hampshire	26	25	Yes^a	25	96.2	83.3	28	26	2	0	25	Yes^a	24	92.3	86.3	31	26	5	0
New Jersey	111	72	Yes	72	64.9	96.6	160	136	4	20	72	Yes^a	72	64.9	96.4	159	136	3	20
New Mexico	56	0		7	12.5	98.1	13	11	1	1	0	Yes^a	18	32.1	57.0	49	24	23	2
New York	183	173	Yes^a	183	100.0	94.1	475	377	44	54	182	Yes^a	180	99.5	92.3	590	365	17	54
North Carolina	124	0		24	19.4	77.1	110	49	56	5	0	Yes^a	39	31.4	67.5	163	79	76	8
North Dakota	50	0		1-4	<10.0	72.2	3	2	0	1	0		1-4	<10.0	68.8	8	3	4	1
Ohio	240	0		20	8.3	74.2	88	36	43	9	0		32	13.3	74.1	115	59	47	9
Oklahoma	149	51		51	34.2	82.8	76	68	7	1	51		51	34.2	90.5	107	70	34	3
Oregon	66	44	Yes^a	47	71.2	84.1	73	58	14	1	42	Yes	48	72.7	82.4	79	59	19	1
Pennsylvania	251	251	Yes^a	235	93.6	83.5	1,616	326	1,246	44	215	Yes^a	226	90.0	83.5	1,586	317	1,223	46
Puerto Rico	65	0		0	0	.	.	.	.	.	0		0	0	.	.	.	.	.
Rhode Island	16	0		1-4	<10.0	58.3	1	1	0	0	0		1-4	<30.0	38.6	11	6	4	1
South Carolina	79	79	Yes^a	72	91.1	58.1	433	106	324	3	79	Yes^a	74	93.7	88.0	425	101	323	1
South Dakota	65*	0		0	0	.	.	.	.	.	0		1-4	<10.0	38.9	3	2	1	0
Tennessee	148	71	Yes^a	78	52.7	92.4	192	149	17	26	80	Yes^a	91	61.5	77.9	306	168	111	27
Texas	641	0		16	2.5	69.2	50	39	5	6	0		83	12.9	44.4	204	131	55	18
Utah	45	0		1-4	<10.0	8.3	1	1	0	0	0		1-4	<10.0	13.9	3	2	1	0
Vermont	13	8		8	61.5	95.5	11	10	0	1	8		8	61.5	94.2	10	10	0	0
Virginia	81	77	Yes	78	96.3	91.7	143	130	7	6	77	Yes^a	81	100.0	84.9	203	136	60	7
Washington	106*	62	Yes^a	64	58.5	89.3	112	81	15	16	62	Yes^a	66	62.3	92.8	116	81	19	16
West Virginia	64	M	Yes	38	59.4	60.7	73	55	18	0	36	Yes	38	59.4	68.0	105	55	49	1
Wisconsin	137	0		13	9.5	81.2	43	21	17	5	0	Yes^a	42	30.7	54.5	179	61	109	9
Wyoming	29	0		0	0	.	.	.	.	.	0		0	0	.	.	.	.	.
All- U.S.	6,139			1,695	27.6	82.0	5,493	2,788	2,350	355			2,403	39.1	76.4	8,904	3,760	4,615	529

Footnotes for Tables 1a, 1b and 1c:

United States, Washington, D.C., and Puerto Rico.
Data included in this report are from 2009 (CLABSI, SSI) and 2010 (CLABSI, SSI, CAUTI) from acute care facility ICUs (critical care units), NICUs (see 9), and wards (for this report wards also include stepdown, specialty care areas [including hematology/oncology, bone marrow transplant], LTAC locations [or facilities]). Long–term care facilities (skilled nursing facilities) and dialysis locations are not included in this report.
The number of acute care facilities reported to CDC by the state health department. Where indicated by a “*,” this number was taken from the 2009 American Hospital Association survey of healthcare facilities and acknowledged by the state.
The number of acute care facilities eligible to report the HAI type under a mandate; for states in which a mandate exists to report that HAI type to the state health department using NHSN at the beginning of each reporting period. This number is reported to CDC by the state health department. If no mandate existed at the beginning of a reporting period, this number is zero. If no mandate existed at the beginning of a reporting period, but was implemented during the reporting period, the value of this column is “M” for midyear implementation. These values are presumed to be constant over sequential reporting periods unless update provided by state health department. Since mandates regarding surgical procedures vary greatly in type of procedure, the presence or absence of a mandate involving any surgical procedure for acute care facilities is indicated by Yes/No.
Yes indicates that the state health department reported the completion of any of the following validation studies of NHSN data reported during the reporting period: data quality assessment of missing or implausible values and/or detection of outlier facilities (e.g., number of infections, rates, denominators). Yes^a indicates that the state completed one or both of these activities and also conducted an audit of medical records. Information on validation efforts was requested from all states, regardless of presence of a legislative mandate for the particular HAI type. Some states without mandatory reporting of a given HAI have performed validation on NHSN data that is voluntarily shared with them by facilities.
This measure is calculated using multiple data sets. It is calculated by dividing “No. of Healthcare Facilities Reporting” by “No. of Healthcare Facilities,” and multiplying by 100. The denominator comes from either the state health department’s self-reported data, or the 2009 AHA dataset. The numerator comes from the NHSN system, and includes all facilities for which data were reported for at least one month during the 12 month reporting period. For CLABSI, this does not include facilities for which zero central line-days were reported for all 12 months; for CAUTI this does not include facilities for which zero urinary catheter-days were reported for all 12 months; for SSI, this does not include facilities for which zero of the selected procedure types were performed for all 12 months. In states for which the AHA count is acknowledged by the state as the best estimate of number of healthcare facilities, this percentage assumes that all NHSN facilities are included in the AHA facilities count; that is, that the NHSN facilities are a subset of the AHA facilities. However, the AHA data do not necessarily comprise the total pool of facilities eligible to participate in NHSN. There are some AHA facilities that are not participating in NHSN; also, there are some facilities within the NHSN system that are not included in the AHA list. In states with a mandate to report HAI data using NHSN, some facilities in the number provided by the state health department (or in the AHA number) might not be included in mandate (e.g., facilities do not have the units or perform the procedures covered by the mandate; or the mandate covers only facilities above a certain bed size); or, some facilities included in the mandate might have reported zero central line-days, zero urinary catheter-days, or zero of the procedure types performed, for the full 12-month period.
This metric is the rate at which facilities submitted data to NHSN during the reporting period. It is calculated by dividing the number of months of data submitted to NHSN by the total number of months of data eligible to be submitted, and multiplying by 100. For CLABSI or CAUTI, a month in which zero device days were reported is not counted in the numerator; for SSI, a month in which zero of the procedure types were performed is not counted in the numerator. For SSI, this is calculated by dividing the number of months that at least 1 procedure was reported to NHSN by the total number of months any procedure could have been reported, multiplied by 100. For example, if a state has two facilities reporting to NHSN, then 24 total months of data could have been submitted to NHSN in a 12-month period. If those two facilities sent in 24 total months of data, the state participation percent is 100%. If one facility submitted data for 8 months and the other for 4 months, then the state participation percent is 50% (data were reported for 12 of 24 total months). For states with a mandate, it is possible for this percentage to be <100 for several reasons, including that some facilities reporting might not be covered by the mandate, might only be submitting selected months of data, or might not have had any central line-days, urinary catheter-days or performed any procedures in a given month to report.
NICU locations included are those classified by NHSN CDC location codes as Level II/III and Level III neonatal critical care areas. A Level II/III neonatal critical care area is defined by NHSN as: combined nursery housing both Level II and III newborns and infants. A Level III neonatal critical care area is defined by NHSN as: a hospital NICU organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness. Level III is subdivided into four levels differentiated by the capability to provide advanced medical and surgical care.
SSIs included are those following select surgical procedures approximating procedures covered by SCIP, using NHSN-defined SSIs that were classified as deep incisional or organ/space, and were detected during admission or upon readmission. The SCIP procedures are listed in Appendix A.