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Form 0920-0978 MRSA SO Supplemental Survey
ICR 201902-0920-001 · OMB 0920-0978 · Object 89456901.
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Form approved OMB No. 0920-0978 Expires xx/xx/xxxx 2019 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Please answer the following questions for the year 2018. The purpose of the survey is to verify and document current surveillance procedures, including cases ascertainment and auditing methods. Please return an electronically completed copy or scanned copy of the completed survey to gqv8@cdc.gov. If you have any questions, please contact Kelly Jackson (gqv8@cdc.gov). Site: ___ CA ___ CT ___ GA ___ MD ___ MN ___ NY ___ TN Person(s) Completing the Form: ___________________________ Surveillance Area Characteristics 1. Is MRSA reportable at your site? _______ yes _______ no a. If yes: i. What is your reportable definition of MRSA? _______ All invasive MRSA statewide _______ Invasive MRSA in residents among defined catchment area _______ Healthcare-associated invasive MRSA infection _______ Other, please define: ___________________________________ ii. Is isolate submission to the State Health Department Laboratory required? _______ yes _______ no b. If no: i. What mechanism do you have in place that allows for SOs to have access to case counts and medical records? _______ Agent of the state _______ State Health Department Regulation _______ Other, please explain: __________________________________ ii. Does your state/site plan to make MRSA reportable? ______yes _______no 2. Did your site send MRSA isolates to CDC for characterization in 2017? ______yes _______no a. If yes, how were isolates selected? ___________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 3. How does your site complete SA case report forms (please select all that apply)? _______On a computer or tablet _______With paper and pen _______Other, please explain: ________________________________ 4. Did your site participate in MSSA surveillance in 2017? ______yes _______no a. If yes, what mechanism did you have in place that allowed for SOs to have access to MSSA case counts and medical records? _______MSSA is a reportable condition _______ Agent of the state _______ State Health Department Regulation _______ Other, please explain: __________________________________ Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a current valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Rd NE, MS D-74, Atlanta, Georgia 30329; ATTN: PRA (xxxx-xxxx) b. If yes, please complete the date range for which MSSA surveillance was conducted in 2017 (month/year) as well as the catchment area: 2017 Dates of MSSA surveillance Catchment area 5. Are you able to directly access any National Healthcare Safety Network (NHSN) data? _______ yes _______ no a. If yes: i. Please mark which NHSN data your site can access _______ Hospital MRSA LabID event _______ Hospital central line-associated bloodstream infection (CLABSI) data _______ Dialysis event b. If no: i. Does a public health partner have access to NHSN data? For example, if your site is not based at the state HD does the state HD have access to the data? If your site is part of the state HD and you do not have direct access to the NHSN data, does another department/section have access to the data? _______ yes _______ no 1. If yes: a. Please mark which NHSN data can be accessed _______ Hospital MRSA LabID event _______ Hospital CLABSI data _______ Dialysis event 3. How often do you access/are you provided with NHSN data? _______ Weekly _______ Monthly _______ Never _______ Other, please specify ___________________________________ 4. What do you use NHSN data for?____________________________________________________ _________________________________________________________________________________ Lab Participation and Case Finding Please answer the following questions for hospitals and labs under surveillance for 2017. 1. Please list the total number of each type of lab serving your MRSA surveillance catchment area (both inside and outside of the catchment area): Inside catchment area Outside catchment area Hospital laboratories Dialysis referral laboratories Commercial/outpatient laboratories* Other; please specify:_______________________________ Total number (Add above together) *For the purpose of the survey, we are defining “Commercial/Outpatient Laboratories” as any for profit laboratory, not including dialysis referral laboratories, that serve health care facilities in a given surveillance catchment area. Examples include LabCorp and Quest. 2. Please list the total number of each type of lab serving your MSSA surveillance catchment area if different catchment than MRSA (both inside and outside of the catchment area): Inside catchment area Outside catchment area Hospital laboratories Dialysis referral laboratories Commercial/outpatient laboratories* Other; please specify:_______________________________ Total number (Add above together) *For the purpose of the survey, we are defining “Commercial/Outpatient Laboratories” as any for profit laboratory, not including dialysis referral laboratories, that serve health care facilities in a given surveillance catchment area. Examples include LabCorp and Quest. 3. Please indicate the culture sources your site requests from participating labs for surveillance other than blood, CSF, pleural fluid, peritoneal fluid, pericardial fluid, joint/synovial fluid, bone, and muscle? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Indicate the percentage contribution of each case finding method to your site’s total SA case counts (100%) in 2017. Case Finding % MSSA % MRSA Method Method Used? Case Count Case Count Contribution Contribution Y N NETSS/NEDSS or other passive state reporting system Y N Retrospective review of received line lists from hospital labs Y N Routinely received line lists from commercial/outpatient labs Y N Routinely received line lists from dialysis referral labs Y N Regular lab visits; frequency:_______________ Y N ICPs submitting case report form Y N Isolates being received at state lab Y N NHSN Y N Other, please specify______________________________ a. Do you expect this distribution and/or percentage values to change in 2017? _______ yes _______ no i. If yes, please explain why: ________________________________________________________________________ ________________________________________________________________________ 5. For labs reporting invasive SA, how many of the participating labs are providing case reports through direct electronic messaging, such as HL7 messaging? ________ a. If less <100%, how else are you receiving reports? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ b. What are the perceived barriers to use of direct electronic messaging? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ b. How important is electronic messaging for your site? (1-- not important at all; 5--very high priority) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Did any labs drop out of participation in 2017? _______ yes _______ no a. If yes, how many? _______ b. Why did these labs drop out of participation? __________________________________________________________________ __________________________________________________________________ 7. In 2017, did you identify any additional labs, regardless of location, which identify invasive SA isolates from persons who are residents of your catchment area? _______ yes _______ no a. If yes, how did you find these labs? ______________________________________________________________________ b. If yes, how many labs did you find? _________ c. If yes, how many of these labs were added? _______ i. If not all found labs were added, why not?______________________________________________________________ __________________________________________________________________ d. Approximately how many cases does this/these lab(s) identify each year among residents of your catchment area? _______ Data Edits 1. Does your site run a data edit program in addition to the CDC edit program that is sent out monthly? _______ yes _______ no a. If yes, how often: _______ Monthly _______ Quarterly _______ Other time frame, specify: ______________________________________ _______ Never b. If yes, what types of edits are you running? Do you think they would be helpful to add to CDC’s edit process? ______________________________________________________________________________ ______________________________________________________________________________ Ascertainment of Surveillance Area* and Case Audits* *“Case ascertainment” should include ongoing attempts to identify new or additional laboratories inside and outside of your defined catchment area which may be processing MRSA specimens for surveillance area residents. *Audits of all laboratories both within the ABCs MRSA surveillance area and those outside are required once a year. The purpose of the audit is to ensure that all cases of invasive MRSA are being captured. The primary data source at every reporting laboratory (e.g. laboratory log slips/log book, computergenerated electronic printouts, case reports, line lists) should be reviewed for invasive MRSA cases and compared to the list of cases that were reported to the surveillance personnel. 1. How did your site define an audit case in 2017? _________________________________________________________________________________ _________________________________________________________________________________ 2. Indicate the percentage contribution of each case finding method to your site’s audit counts (100%) in 2017. Audit Method % MSSA % MRSA Method Used? Audit Count Audit Count Contribution Contribution Y N NETSS/NEDSS or other passive state reporting system Y N Retrospective review of received line lists from hospital labs Y N Routinely received line lists from commercial/outpatient labs Y N Routinely received line lists from dialysis referral labs Y N Regular lab visits; frequency:_______________ Y N ICPs submitting case report form Y N Isolates being received at state lab Y N NHSN comparison Y N Other, please specify______________________________ 3. Does your site assess your individual laboratory case auditing* methods? *Audits of all laboratories both within the HAIC MRSA surveillance area and those outside are required once a year. The purpose of the audit is to ensure that all cases of invasive MRSA are being captured. The primary data source at every reporting laboratory (e.g. laboratory log slips/log book, computer-generated electronic printouts, case reports, line lists) should be reviewed for invasive MRSA cases and compared to the list of cases that were reported to the surveillance personnel. _______ yes _______ no a. If no, please explain why: ___________________________________________________________________________ ___________________________________________________________________________ b. If yes, how often is this performed? When was this last performed? ___________________________________________________________________________ ___________________________________________________________________________ c. If yes, how does your site perform audits*? _______ Remove negative restrictions from line list reports _______ Review actual query codes _______ Review selection criteria _______ Other, please specify_______________________________________________ i. If you picked “Review actual query codes”, can you see pathogen resistance information? For example, in the query code can you see that the laboratory is including isolates resistant to oxacillin for MRSA? _____Yes _____No 4. Does your site perform routine ascertainment* of the surveillance area? *“Case ascertainment” should include ongoing attempts to identify new or additional laboratories inside and outside of your defined catchment area which may be processing specimens for surveillance area residents. _______ yes _______ no a. If yes, how does your site assess case ascertainment* methods? (examples include: physician surveys, LTCF surveys, outreach to new dialysis centers, etc…). ________________________________________________________________________ ________________________________________________________________________ b. If yes, how often is this performed? When was this last performed? ________________________________________________________________________ ________________________________________________________________________ 5. Are there specific labs that you have difficulty obtaining line lists from? _______ yes _______ no a. If yes, what types of labs? ______________________________________________________ ______________________________________________________________________________ 6. Does your site have checks in place to recognize decreasing/increasing case counts or rates of MRSA disease? _______ yes _______ no a. If yes, please describe the check(s) that you use____________________________________ ____________________________________________________________________________ b. If yes, how often are the check(s) used? _______________________________________ c. If yes, do you plan to use these for MSSA once more surveillance data are available? _______ yes _______ no Geocoding 1. Is your site continuing to geocode SA cases? _______ yes _______ no CDC Responsibilities 1. CDC staff are responsive to questions/concerns/emails (e.g., Valerie Albrecht, Kelly Jackson, Isaac See, and Shirley Zhang). _______ Strongly agree _______ Agree _______ Neutral _______ Disagree _______ Strongly disagree a. If you disagree or strongly disagree, please explain and provide improvement suggestions: ______________________________________________________________________________ ______________________________________________________________________________ 2. Monthly surveillance officer calls are a valuable use of my time. _______ Strongly agree _______ Agree _______ Neutral _______ Disagree _______ Strongly disagree a. If you disagree or strongly disagree, please explain and provide improvement suggestions: ______________________________________________________________________________ ______________________________________________________________________________ 3. What parts of the SA SharePoint site do you use the least or find the least useful? _________________________________________________________________________________ _________________________________________________________________________________ 4. Can you suggest any future training topics that might be useful for SA surveillance officers? ______________________________________________________________________________ ______________________________________________________________________________ 5. What SA topics would you like to see covered at the HAIC Surveillance Officer’s Meeting during the SA session next year? ______________________________________________________________________________ ______________________________________________________________________________ END Thank you very much!
| File Type | application/pdf |
| File Title | 2005 ABCs Survey for Annual Surveillance Officers Meeting |
| Author | cfw3 |
| File Modified | 2018-10-02 |
| File Created | 2018-10-02 |