Ensuring Accuracy in HAI Surveillance: A Call for Competency Validation
Accurate surveillance of healthcare-associated infections (HAIs) is not just a cornerstone of infection prevention—it’s a critical determinant of patient safety, regulatory compliance, and financial stability for healthcare facilities. Despite its importance, surveillance remains most time consuming task in an infection preventionist’s (IP’s) day, and its accuracy is often taken for granted.
Healthcare facilities rely on infection preventionists to correctly apply National Healthcare Safety Network (NHSN) definitions when reporting HAIs. These reports influence internal quality improvement efforts, external evaluations, and even federal reimbursement. Yet, there is currently no mandated initial or annual training requirement for IPs entering data into NHSN. While NHSN offers educational resources and annual training, participation is voluntary, and the fast-paced nature of the IP role often limits engagement with these materials.
The consequences of inaccurate surveillance are significant. A large-scale study involving nearly 8,000 IPs over six years revealed a correct response rate of only 62.5% on NHSN case studies—meaning infections were incorrectly coded in more than one-third of test cases. These errors can compromise internal data integrity, hinder performance improvement, and expose facilities to regulatory citations and financial penalties.
Recognizing this gap, IP&MA has prioritized the development of tools and training programs to validate and enhance surveillance competency. Our research shows that participants who repeatedly participated in surveillance competency testing had consistently higher scores than first time testers and upward trends have been observed over time. Interrater reliability testing for surveillance accuracy, combined with regular education on NHSN protocols, hands-on practice and peer validation, can improve your team’s surveillance accuracy.
To support the broader infection prevention community, we now offer two key resources:
NHSN Infection Surveillance Bootcamp: A comprehensive 7-hour video-based training course covering NHSN definitions, case studies, and practical surveillance examples.
Infection Surveillance Interrater Reliability Assessment: A validated exam using clinical scenarios to assess mastery of NHSN definitions, complete with rationales to reinforce learning.
These tools are designed to build confidence, ensure consistency, and most importantly, validate the surveillance competency of infection preventionists. In an era where data drives decisions, we must ensure that the data is accurate—and that begins with skilled, validated professionals.