CDPH Toolkit for California Hospitals Tracking Antimicrobial Use and Resistance
Among 399 California hospitals, 132 (33.1%) are submitting data into the National Healthcare and Safety Network (NHSN) Antimicrobial Use (AU) option and 66 (16.5%) are submitting data into the Antimicrobial Resistance (AR) option.
Percentage of Hospitals Submitting Data into the NHSN AU Option by County
This toolkit serves as a one-stop resource for California hospitals interested in implementing the NHSN Antimicrobial Use and Resistance (AUR) Module. The NHSN AUR Module provides a mechanism for hospitals to track, analyze and compare antimicrobial use and resistance data. Hospitals can use the AUR module to inform local or system-wide efforts to reduce antimicrobial resistant infections through antimicrobial stewardship and infection prevention. The target audience for this toolkit includes physicians, pharmacists, infection preventionists, microbiologists, hospital leadership and any other staff seeking guidance, resources, and practical examples for implementing the NHSN AU and/or AR option. Please note this toolkit is not a replacement for CDC guidance.
How to Participate
To participate in either the AU or AR option of the AUR module, hospital personnel responsible for reporting NHSN data must coordinate with their laboratory and/or pharmacy information software providers to configure their system to generate standard formatted file(s) for importation into NHSN. The format for data submission follows the Health Level (HL7) Clinical Document Architecture (CDA). Manual data entry is not available for the AUR Module. Hospitals can participate in one (AU or AR) or both (AU and AR) options, and can implement them in either order.
Where to Start (either AU or AR)
- If your hospital is in the decision-making process, begin with Element 1 for guidance on software solution approaches and investments.
- If your hospital has started the implementation process, jump to Element 5 for guidance on data verification and submission.
Antimicrobial Use (AU)
Implementation Elements 
| Antimicrobial Resistance (AR)
Implementation Elements
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āElement 1: AU Program IntroductionThis section provides an overview of the AU program. AU program trainings: | āElement 1: AR Program IntroductionThis section provides an overview of the AR program. AR program trainings: |
āElement 2: AU Program RequirementsThis section provides an overview of systems and data elements needed for calculating an AU report. | āElement 2: AR Program RequirementsThis section provides an overview of systems and data elements needed for calculating an AR report. |
āElement 3: Calculating an AU ReportThis section provides an overview of how an AU report is calculated. | āElement 3: Calculating an AR ReportThis section provides an overview of how an AR report is calculated. |
āElement 4: CDA and Validation for AU and AR ReportsThis section provides an overview of the CDA format for AU and AR reports and how to ensure they are valid CDA documents.
File validation ensures correct report formatting; it does not verify that the reported values are accurate. |
āElement 5: Verification of AU ReportsThis section provides an overview of how to review generated AU reports to ensure the contents within the files were calculated correctly and accurate. | āElement 5: Verification of AR ReportsThis section provides an overview of how to review generated AR reports to ensure the contents within the files were calculated correctly and accurate. |
āElement 6: AU Success StoriesThis section contains case studies of successful AU implementation by California hospitals. Learn what benefits they gained through successful AU reporting. | āElement 6: AR Success StoriesThis section contains case studies of successful AR implementation by California hospitals. Learn what benefits they gained through successful AR reporting. |
āElement 7: Additional Support
- Need help choosing which program to implement and what resources are needed? Or help with CDA and report validation and verification? E-mail us at HAIProgram@cdph.ca.gov and we can discuss available resources and support.
- If you are an information technology specialist implementing AU or AR at a facility, additional technical information is provided by CDC, at the NHSN CDA Submission Support Portal.
- For general support, contact the NHSN Help Desk.
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