National Healthcare Safety Network: A Vital Hub for Tracking Infectious Diseases

By Lynne Batshon, Director, Policy & Practice at the Society for Healthcare Epidemiology of America

The National Healthcare Safety Network (NHSN) is the nation’s most widely used surveillance system for tracking and collecting data on the prevalence of healthcare associated infections (HAIs), multi-drug resistant organisms (MDROs), and antibiotic prescribing trends on a facility, state, federal level. Used by 38,000 healthcare facilities along with the Centers for Disease Control and Prevention (CDC), state and local public health departments, and medical researchers, NHSN serves as the primary hub for healthcare associated infection data collection for nearly all hospitals, nursing homes, dialysis facilities, and ambulatory surgery centers.

About one in 31 hospitalized patients (3.2%) develops at least one HAI and accounts for billions in direct costs each year.[1] Established in 2005, NHSN is the most comprehensive and recognized system to capture and analyze data that informs healthcare facility quality improvement interventions, mitigation strategies, and outbreak responses to HAIs. NHSN can identify preventable HAI problems occurring within individual healthcare facilities to allow for data-driven decision making to reduce the risk of HAIs and stop the spread of MDROs and then benchmark progress on those facilities' infection prevention efforts. Further, NHSN is a critical component of antibiotic stewardship. Antibiotic use data is now collected and analyzed in order to optimize antibiotic prescribing practices to reduce the prevalence of MDROs. NHSN has become integral not just to providers seeking to improve patient safety, but government agencies such as the Centers for Medicare and Medicaid Services (CMS) that use the data for quality reporting and incentive payment programs for healthcare facilities.

NHSN is a success story that has exceeded expectations. But annual funding has not kept up with the rapid growth of the program. NHSN has expanded beyond its original intended capacity of 17,000 facilities while funding has remained relatively flat.

Among the learnings that emerged from the COVID-19 pandemic was the critical importance of timely data surveillance and the nation benefited from large, one-time investments made possible through American Rescue Plan supplemental funding[2] to upgrade and modernize NHSN. By FY 2026, modernized NHSN capabilities will be fully realized and automated data capture and exchange will be freely available to facilities across the healthcare spectrum. However, when supplemental funds end, CDC will be unable to maintain important improvements at the current funding level.  

To meet demands for disease surveillance systems, the supplemental funding provided by American Rescue Plan must be sustained to ensure the fully modernized and automated NHSN is not interrupted by a lack of adequate funds. The most recent HAI Progress Report shows the incidence of HAIs in 2023 has continued a downward trend for our most serious and preventable HAIs compared to 2022 rates. Tracking this progress and identifying effective interventions is only possible with the support of the NHSN.   Enhanced automation will alleviate the administrative burden for healthcare personnel allowing them to focus on high-value patient-focus HAI and MDRO reduction efforts, rather than manual data entry. It will also enable faster, richer, real-time data collection from healthcare facilities allowing for earlier detection of emerging threats and more targeted interventions. The full potential of the NHSN is not yet realized at this time and we cannot allow our momentum to slow down.

The current $24 million in annual appropriations is not enough to adequately maintain these investments. In order to sustain a fully modernized NHSN beyond FY 2026, annual appropriations must be increased to $50 million. Congress must increase base-level annual appropriations to ensure NHSN can sustain critical efforts toward reducing HAIs and MDROs. We must protect the investments already made and provide the resources to sustain NHSN so it can fulfill its promise to the American people.

[1] “Current HAI Progress Report.” Centers for Disease Control and Prevention, 6 Nov. 2024, www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html. Accessed 20 Nov. 2024

[2] “CDC to Invest $2.1 Billion to Protect Patients and Healthcare Workers from COVID-19 and Future Infectious Diseases.” Centers for Disease Control and Prevention, 17 Sept. 2021, archive.cdc.gov/#/details?q=american%20rescue%20plan%20funding%20for%20nursing%20homes%20CDC%20funding&start=0&rows=10&url=https://www.cdc.gov/media/releases/2021/p0917-COVID-19-funding.html. Accessed 20 Nov. 2024