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									DIGITAL CERTIFICATES:

Will my digital certificate expire?
Yes. Digital certificates expire after one year and cannot be renewed. Each year, you can apply for a new
digital certificate.


How do I know when my digital certificate will expire?
NHSN will notify you via email 30 days prior to your digital certificate's expiration date. This email will
include instructions on how to proceed, including the website and password.
NOTE: You should not apply for a new digital certificate prior to receiving the notification from NHSN.


What if I don't apply for a new digital certificate after my current digital certificate has
expired?
That's okay. You can still apply for a new digital certificate, using the website and password included in
the email from NHSN. Once a digital certificate has expired, however, you will not be able to access NHSN
until a new digital certificate is installed.


Can I use my current digital certificate while the application for my new digital certificate
is pending?
No. Once you have applied for a new digital certificate, your expiring digital certificate will no longer
work. You should receive your new digital certificate within 48-72 hours of applying.


I have received an email from the Secure Data Network (SDN) with my digital certificate,
but I don't remember how to install it. Where can I find instructions?
Instructions for installing a digital certificate can be found in the NHSN User Start-up Guide Step 3d. It
is also recommended that you have a back-up copy of the digital certificate on a thumb-
drive or disc and stored in a secure place.


Do I have to create a new challenge phrase?
No, you are not required to create a new challenge phrase. You can use the same challenge phrase from
your expired digital certificate.


My application for a digital certificate has been denied. What do I do?
Contact NHSN at nhsn@cdc.gov.


Is it possible to obtain a digital certificate for a new associate?
Yes. A facility can have only one NHSN Facility Administrator and one Primary Patient Safety Contact,
but it is possible to have up to a total of 20 users. Users are added from the “Manage Users” section of the
Navigation Bar by the NHSN Facility Administrator. A digital certificate is user-specific. Each person
who uses NHSN will need to obtain her/his own unique digital certificate and install it onto one or more
computers she/he will use to access NHSN. Multiple digital certificates can be installed on a single
computer. Digital certificates should never be shared among users.
Can clerical and/or non-clinical people be trained to enter data in NHSN?
Yes, and specifically for the Lab ID Event entry, this is probably a very cost/time-effective alternative to
having IP‟s do all of the data collecting and data entry. However, it is imperative that the IP do all of the
algorithm calculation, determination, and judgment of infection events.


When saving an entered event, I am directed back to the Sign-In screen and asked for my
pass code. What has occurred?
Your session has timed out and the information you input has not been saved. You will need to re-enter
the data. TIP: Hit the „SAVE‟ button frequently and prior to hitting the „ENTER‟ button to better ensure
your data is recorded. You may also want to time the occurrences and advise CDC if you feel the „time out‟
period is too short.



In the CLABSI and MDRO Modules, the numbers of patient days do not match. Which
number should I use since it will not let me enter the correct ones?

If you are using both modules, it will cross populate the number of days, use the number that is the more
accurate source, it may mean going in and correcting the module that is cross populating

I am doing the “AST” piece and am finding that my number of admits are different than my
number populated by NHSN. Which one is correct?

NHSN has underlying Business Rules that mean that you cannot perform more ASTs than the number of
admissions (i.e., cannot have > 100% of admissions). You may need to adjust the admissions number
(you need to judge whether your manual or administrative data is the more accurate and enter that).

How long does it take to determine Lab ID event data for each unit, each month once the
report is received from the laboratory? How long does it take to actually enter the Lab ID
event data for each unit, each month?
More time is spent on researching if the patient has a history of MRSA and making the determination vs.
actually entering the data. IP‟s whose facilities already „flag‟ MRSA patients have a greater time advantage
over those who do not have this implemented.


Are there time-saving ways of reporting data to THA, QSource, and MedMine?
The MRSA event data (numerator/denominator) can be extracted from NSHN and shared w/ THA,
QSource, and the TN Department of Health with a signed data release form. Please note: THA only
counts the Lab ID event, not the infection event.
Can I edit or add data that is considered „old‟?
Yes, CDC recognizes that there are instances in which an infection is not identified until numerous days
after surveillance; however, it is best to enter data as soon as you get it.


Do I enter data from a 23 hour observation?
Outpatient vs. Inpatient status is determined by calendar days, not hours observed, according to CDC‟s
definition. Example: if a patient is admitted to the ED at 11:55 pm and discharged at 12:10 am (15
minutes later), they are considered a NHSN admission.
If the patient under the 23 hour observation is not admitted, how do I enter the event?
You don‟t. If the patient is admitted to the ED at 12:10 am and is discharged on the same calendar day at
11:55 pm, he is classified as an outpatient. NHSN will not allow you to enter information as the location
field goes away.


If a person initially observed as an outpatient is admitted with MRSA to the same facility 2
months later, how are they classified?
The same criterion as above applies and person is considered a new, community-onset NHSN admit.
(This is the true, technical definition, however, your facility may not administratively classify this way)


When entering infection surveillance patient days as zero and admission days as zero, do
we need to type in the zero or is it automatically calculated as zero?
It is not necessary to type in zeros for the numerators. It is, however, absolutely necessary to enter your
denominator data. Otherwise, it is assumed that you are not reporting.
If I have a patient who is MRSA-positive on admission, 7 days later he is cultured again,
and 3 weeks later cultured again ( all cultures same-site <respiratory> but different
months), how is he classified?

First he will be classified as community onset. Then, he will be changed to hospital onset. He will not be
reported as an incidence case as the system recognizes that this person has been there before.

CDC recognizes that the Lab ID and Infection Events data are not perfect. They are looking, rather, at
how the 2 measures perform and are following trends for quality improvement purposes in hopes of
creating sustainability for capturing the data. Numbers aren‟t the same, but the trends and percentage
changes should be.

What improvements to the Module are being planned?

 CDC is fully aware of the lag times and the screen-outs and are planning to make improvements in these
areas. At this time, however, their number one priority is to create the capability to accept electronic
messaging, i.e., lab reports and data transfers into the module. They are feverishly working on the
capacity to generate electronic lab reports from each facility using standard vocabulary and push this
directly down to NHSN, giving the hospitals an opportunity to monitor multiple units consecutively rather
than one.

								
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