Evolution of hospital participation in the National Nosocomial Infections Surveillance System, 1986 to 1993.

OBJECTIVE

To study changes in the use of National Nosocomial Infections Surveillance System (NNIS) surveillance components since 1986 that could reflect an evolution in the way in which NNIS hospitals conduct surveillance of nosocomial infections.

METHOD

We analyzed NNIS data from 1986 to 1993 collected at the 199 US hospitals that participated in the NNIS system during this period.

RESULTS

The number of hospitals participating in the NNIS system increased threefold between 1986 and 1993. A parallel increase was noticed in the amount of surveillance data for all NNIS components except for the hospital-wide component. The percentage of all hospitals reporting at least 1 calendar month per year of data from the hospital-wide component decreased from 95% in 1986 to 37% in 1993. During this period, use of the hospital-wide component was greater among the hospitals whose first participation in the NNIS system occurred before 1987.

CONCLUSION

Interest by NNIS hospitals in the hospital-wide component apparently decreased between 1987 and 1993. In contrast, the interest in NNIS components that allow calculation of risk-adjusted nosocomial infection rates (intensive care unit, high-risk nursery, and surgical patient components) increased dramatically after 1986. This increased interest in surveillance with NNIS components that allow risk adjustment and interhospital comparison of infection rates suggests that the feasibility of collection of and interest in such data are high.