Hospital Settings

Hospital Settings

Background

Hospitals offer a place to get diagnosed, treated, or rehabilitated. Hospital settings include:

  • Acute Care Hospitals
  • Children's Hospitals
  • Critical Access Hospitals
  • Long-Term Acute Care Hospitals
  • Psychiatric Hospitals
  • Inpatient Rehabilitation Facilities

Special considerations for infection prevention in these settings:  

  • CDC Interfacility Transfer Form - The patient transfer form helps make it easier to share information when patients are moved between different places for care. Hospitals and groups focused on making patient safety better can change and use this form to fit their needs.

VDH Infection Prevention and Control Assessments

Our team is available to conduct no cost, consultative, non-regulatory, and non-punitive onsite assessments for infection prevention and control (IPC) programs in Virginia.

Benefits of Collaborating with VDH for IPC Assessments:

  • The VDH Team can help strengthen your facility’s IPC program and activities
  • IPC Program improvements make your facility safer for patients and staff
  • VDH experts can answer your questions and provide education and training at no cost

What to Expect at your IPC Assessment: 

  • Before the in-person assessment, VDH will ask you some demographic questions to understand your facility better. 
  • During the visit, VDH staff will tour your facility to learn and observe IPC practices.
  • After the visit, VDH staff will:
    • Provide a written summary of facility strengths and recommendations for IPC improvement
    • Offer follow-up discussion
    • Supply resources and education tailored to your needs

 

 

 

Educational Resources

General resources for hospital settings

 

Return to the Resources Hub to view all healthcare settings. 

Healthcare-associated infections and antimicrobial resistance (HAI/AR) topic webpages with resources specific to hospital settings:

 

Return to the Resources Hub to view all HAI/AR topics. 

 

 

 

Data & Reporting

National Healthcare Safety Network (NHSN)

On March 21, 2005, the Virginia General Assembly approved House Bill 1570 that amended the Code of Virginia (by adding §32.1-35.1) to make information on selected nosocomial (i.e., healthcare-associated) infections reportable to VDH through NHSN. The Code further directed the Board of Health to develop regulations that specify the infections to be reported and the patient populations to be included. After significant consultation with stakeholders to determine the kind of data that would be both reliable and useful, the Regulations for Disease Reporting and Control were amended to add a section (12VAC5-90-370) related to HAIs. In Virginia, central line-associated bloodstream infection data from hospital adult intensive (critical) care units have been shared with VDH since July 2008.

On September 25, 2015, the HAI reporting regulations were amended to expand the amount of HAI data that are shared with VDH. The regulations aligned reporting to the state health department with what hospitals are already reporting to NHSN for the purposes of complying with CMS reporting requirements. See Table 1 for measures that are part of the state reporting requirements for acute care hospitals. Note that the table lists the current reporting requirements. VDH reporting requirements will expand as CMS reporting requirements expand.

Table 1. HAI Reporting Requirements for Acute Care Hospitals in Virginia

CMS Reporting Program HAI Event Applicable Units Reporting Start Date
Hospital Inpatient Quality Reporting (IQR) Program Central line-associated bloodstream infections (CLABSI) Adult, pediatric, and neonatal intensive care units July 2008 (VDH); January 2011 (CMS)
IQR Program CLABSI Adult and pediatric medical, surgical, and medical/surgical inpatient wards January 2015
IQR Program Catheter-associated urinary tract infections (CAUTI) Adult and pediatric intensive care units January 2012
IQR Program CAUTI Adult and pediatric medical, surgical, and medical/surgical inpatient wards January 2015
IQR Program Surgical site infections (SSIs) following colon procedures Inpatient procedures January 2012
IQR Program SSIs following abdominal hysterectomy procedures Inpatient procedures January 2012
IQR Program Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events Facility wide inpatients (FacWideIN) including ED, 24-hour observation January 2013
IQR Program Clostridioides difficile (C. difficile) laboratory-identified events Facility wide inpatients (FacWideIN) including ED, 24-hour observation January 2013
IQR Program Healthcare personnel influenza vaccination All inpatient healthcare personnel January 2013

 

Long-term acute care hospitals are acute care hospitals that provide services and treatment for patients who are generally very sick and stay, on average, more than 25 days. There are five long-term acute care hospitals in Virginia.

In February 2019, the Virginia General Assembly passed House Bill 2425, which amended the Code of Virginia (§32.1-35.1) to expand statewide surveillance for HAIs to additional healthcare settings. Under this bill, long-term acute care hospitals (LTACHs) are required to share data with VDH as of July 1, 2019. Data required to be reported to NHSN to meet CMS requirements should be shared with VDH through the NHSN system. See Table 1 for measures that are part of the state reporting requirements for LTACHs. Note that the table lists the current reporting requirements. VDH reporting requirements will expand as CMS reporting requirements expand.

Table 1. HAI Reporting Requirements for Long-Term Acute Care Hospitals in Virginia

CMS Reporting Program HAI Event Applicable Units Reporting Start Date
Long-Term Care Hospital Quality Reporting (LTCHQ) Program Central line-associated bloodstream infections (CLABSI) Adult and pediatric long-term acute care intensive care units and wards October 2012
LTCHQ Program Catheter-associated urinary tract infections (CAUTI) Adult and pediatric long-term acute care intensive care units and wards October 2012
LTCHQ Program Clostridioides difficile (C. difficile) laboratory-identified events Facility-wide inpatients (FacWideIN) January 2015
LTCHQ Program Healthcare personnel influenza vaccination All inpatient healthcare personnel October 2014

 

Inpatient rehabilitation facilities (IRFs) are hospitals, or part of a hospital, that provide intensive rehabilitation services using an interdisciplinary team approach. Admission to an IRF is appropriate for patients with complex nursing, medical management, and rehabilitative needs. There are ten freestanding IRFs and 18 rehabilitation locations within other hospitals in Virginia. 

In February 2019, the Virginia General Assembly passed House Bill 2425, which amended the Code of Virginia (§32.1-35.1) to expand statewide surveillance for HAIs to additional healthcare settings. Under this bill, inpatient rehabilitation facilities (IRFs) are required to share data with VDH as of July 1, 2019. Data required to be reported to NHSN to meet CMS requirements should be shared with VDH through the NHSN system. See Table 1 for measures that are part of the state reporting requirements for IRFs. Note that the table lists the current reporting requirements. VDH reporting requirements will expand as CMS reporting requirements expand. 

Table 1. HAI Reporting Requirements for Inpatient Rehabilitation Facilities in Virginia 

CMS Reporting Program HAI Event Applicable Units Reporting Start Date
Inpatient Rehabilitation Facility Quality Reporting (IRFQR) Program  Catheter-associated urinary tract infections (CAUTI)  Adult and pediatric inpatient rehabilitation facility wards October 2012
IRFQR Program  Clostridioides difficile (C. difficile) laboratory-identified events  Facility-wide inpatients (FacWideIN)  January 2015 
IRFQR Program  Healthcare personnel influenza vaccination  All inpatient healthcare personnel  October 2014 

Reporting

Virginia Communicable Disease & Outbreak Reporting Requirements 

 

 

 

Regulatory Resources

Last Updated: September 20, 2024