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Surveillance & Reporting
Reporting of select healthcare-associated infections (HAI) became mandatory in North Carolina beginning January 1, 2012 (Session Law 2011-386, House Bill 809; 10A NCAC 41A .0106). Infections that are required to be reported in North Carolina are aligned with those of the Centers for Medicaid and Medicare Services' inpatient prospective payment system (IPPS) 
and include:
All state-licensed short-term acute care hospitals (including specialty short-term acute care hospitals), long-term acute care hospitals, and inpatient rehabilitation facilities are required to report HAIs to the N.C. Division of Public Health (DPH). However, reportable HAIs vary by facility type. Below is a table that summarizes which HAIs are to be reported by each facility type:
| HAI | Facility Type | Reporting Start Date |
| CLABSI | Short-term acute care hospitals: Adult, pediatric, neo-natal ICUs |
January 2011 |
| CAUTI | Short-term acute care hospitals: Adult, pediatric ICUs |
January 2012 |
| SSI | Short-term acute care hospitals: Colon, abdominal hysterectomy procedures |
January 2012 |
| CLABSI | Long-term acute care hospitals | October 2012 |
| CAUTI | Long-term acute care hospitals | October 2012 |
| CAUTI | Inpatient rehabilitation facilities | October 2012 |
| MRSA bacteremia | Short-term acute care hospitals including specialty hospitals |
January 2013 |
| C. difficile | Short-term acute care hospitals including specialty hospitals |
January 2013 |
Surveillance is defined by the Centers for Disease Control and Prevention (CDC) as "the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know and linked to prevention and control." (See www.cdc.gov/mmwr/preview/mmwrhtml/su6103a3.htm. )
Surveillance for HAIs in North Carolina is conducted via CDC's National Healthcare Safety Network (NHSN). NHSN is a secure, internet-based patient and healthcare personnel safety surveillance system that is managed by the Division of Healthcare Quality Promotion at CDC. Enrollment is free and open to all types of healthcare facilities, including short-term acute care hospitals, long-term acute care hospitals, psychiatric hospitals and rehabilitation hospitals. NHSN also provides support and training for infection preventionists and hospital epidemiologists who use the system.
Hospitals enter data into NHSN. N.C. DPH is able to access the data in NHSN through a data use agreement. Hospital infection preventionists enter HAI summary data (such as device days, patient admissions, procedures) into NHSN within 30 days of the end of a calendar month. For HAI events, infection preventionists enter data into NHSN within 30 days of identification of the HAI. N.C. DPH works with hospitals on a monthly basis to ensure data entered in NHSN are accurate and complete.
Every quarter, N.C. DPH publishes a HAI year-to-date summary for each hospital. An annual report is published in April. Acknowledging the different data needs of healthcare consumers and healthcare providers, two versions of each report are published. These reports are available on the N.C. DPH HAI website in the "Facts & Figures" section.
In addition to HAI surveillance, N.C. DPH also monitors and responds to outbreaks of HAIs in healthcare settings. Outbreaks of HAI in healthcare settings are reported to local health departments or to N.C. DPH. The N.C. DPH's Communicable Disease Branch works with local health departments and healthcare facilities, at their request, to respond to HAI outbreaks.
Learn more about communicable disease surveillance and reporting in North Carolina.
provides an archived recording of the webinar originally presented July 16, 2013, courtesy of the North Carolina Quality Center (NCQC).
