Healthcare-Associated Infections (HAI) Update - Jan. 2019

Minnesota Department of Health

Healthcare-Associated Infections (HAI) Update

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January 2019

Minnesota Antibiotic Stewardship Conference

The Minnesota Antibiotic Stewardship Conference will be held on May 13, 2019, at the Wilder Center in Saint Paul, MN. There is no cost to attend this full-day conference!
Stay tuned for more details and registration information.

This year, the conference will focus on patient and provider education. Content will be relevant to health care providers, nurses, infection preventionists, administrators, dentists, pharmacists, public health professionals, and more.

Save the Date: 2019 Minnesota Antibiotic Stewardship Conference

Ambulatory Surgery Center HAI Prevention Webinars

Ambulatory Surgery Center Healthcare-Associated Infection (ASC HAI) Prevention Webinars are held monthly. The ASC HAI Prevention Webinars incorporate presentations and interactive discussions focused on specific HAI best practices, tools, and resources to support ASCs in their efforts to reduce HAIs. Participants have the opportunity to take a deep dive into the specific elements of practice to ask questions, share challenges, and connect with ASCs that may have found solutions and success.

Webinars are held on the second Wednesday of the month at 10:00 a.m.

Contact to receive registration instructions.

MDH Findings on the Burden of MSSA and MRSA

Minnesota Department of Health released findings on the Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA in Emerging Infectious Diseases. Find out more about a study done in 2014-2015 that looked at the incidence of invasive methicillin-susceptible Staphylococcus aureus (MSSA) and found it to be twice that of methicillin-resistant Staphylococcus aureus (MRSA) in two counties in Minnesota. The authors found MSSA isolates were more genetically diverse and susceptible to more antimicrobial drugs than methicillin-resistant S. aureus isolates.

Antibiotic Student Video Contest - Now Open!

The Minnesota Department of Health (MDH) invites Minnesota middle and high school students (grades 6–12) to help increase antibiotic awareness through the second annual Lights, Camera, Action for Antibiotics Video Contest!

  • Students will produce a 30-second video to spread the word about antibiotic resistance and good antibiotic use.
  • This is a great opportunity for students to build their design portfolio, schools to use as part of their curriculum, and the public to learn more about the threat of antibiotic resistance.
  • Winning videos will be posted on MDH's website, shared through social media, and used in public service announcements.
  • Submissions are due by Feb. 1, 2019. ​
  • View past contest winning videos and consider using them in waiting rooms to educate patients on this important topic.

Please share this information with students and encourage them to participate!

CHAIN Fall Conference Presentations Now Available

Were you unable to attend the CHAIN (Collaborative Healthcare-Associated Infections Network) conference in September?

No need to worry! Presentation videos and handouts are now available on the 2018 CHAIN Fall Conference website.

Presentations were focused on strategies for reducing urinary tract infections, care transitions, infection prevention, and antibiotic stewardship tracking and reporting.​

Injection Safety Workshop Recordings Now Available

MDH's Injection Safety Workshop: Three-Part Recorded Webinar Series is now available online. Participants must register for each recording to be eligible for CEUs. Safe injections are a part of patient safety!

Topics covered include:

  1. Outbreaks that have occurred as a result of unsafe injection practices
  2. Resources to promote injection safety
  3. Correct use of single-use and multi-dose vials and IV solution bags
  4. Aseptic technique for preparing and administering medication using a syringe and needle
  5. Injection safety and drug diversion
  6. Developing an injection safety program

The recorded webinars can be used in new employee orientation and annual staff competency training.

CDC Alert: Drug-Resistant Infections in Mexico

CDC issued the following notice last week:

The Centers for Disease Control and Prevention (CDC) was notified beginning on September 28, 2018, through the Antibiotic Resistance Laboratory Network of 10 Verona Integron-mediated Metallo-β-lactamase-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) infections among adult patients returning to the United States after undergoing invasive procedures (e.g. endoscopy, surgery) in Mexico. Seven patients reported receiving bariatric surgery in Tijuana, Baja California, Mexico between September and November 2018. Out of these seven, six reported undergoing surgery at Grand View Hospital in the city of Tijuana.

The Mexican government has closed the Grand View Hospital until further notice. CDC recommends that travelers to Tijuana, Mexico, not have surgery at the Grand View Hospital until the Mexican government can confirm that the drug-resistant form of Pseudomonas aeruginosa bacteria is no longer there.

What health care providers need to know:

Please report to your local or state health department any carbapenem-resistant P. aeruginosa surgical site infections in patients following invasive procedures in Mexico. Providers caring for patients with a history of recent invasive procedures in Mexico should be aware of the potential for infections caused by resistant pathogens. For those with signs of infection, U.S. healthcare providers should obtain cultures, perform antimicrobial susceptibility testing to guide treatment, and have any carbapenem-resistant strains of Pseudomonas aeruginosa and Enterobacteriaceae tested for VIM and other plasmid-mediated carbapenemases.

CDC continues to recommend that patients admitted to health care facilities in the U.S. following an overnight stay in a health care facility outside the U.S. (within the last six months) undergo rectal screening for carbapenemase-producing organisms.

Mechanism testing for carbapenem-resistant Enterobacteriaceae (CRE) and CRPA and rectal screening for carbapenemases is available free of charge via the Antibiotic Resistance Laboratory Network, which can be accessed through State-based HAI Prevention Activities.

For patients seeking care outside of the U.S.:

Medical tourism has been associated with complications, including infections caused by antibiotic-resistant strains of bacteria not commonly seen in the U.S. Patients who are considering seeking medical care overseas should be aware of this risk.

CDC’s Bact Facts Interactive is now live!

We are very excited to let you know that Bact Facts Interactive, a new web-based tool that creates custom graphs and tables with current and historical data, is now publicly available from CDC's Active Bacterial Core surveillance (ABCs). As you may know, ABCs reports are available as static web pages and downloadable PDFs. These reports are not interactive and only present a single year of data.

In contrast, Bact Facts Interactive can display several years of data so users can view trends for five pathogens — group A Streptococcus, group B Streptococcus, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae. The tool also allows users to customize what data they see through interactive graphs and tables.

Officially launched in September, Bact Facts Interactive is part of CDC's ongoing commitment to making public health data accessible and useful. CDC believes that sharing data with others in an open, timely, and appropriate way best serves public health and scientific advancement. Please note: Bact Facts Interactive recently added 2016 data.

Since 1995, MDH has been a strong collaborator in the multi-site ABCs network. Surveillance and epidemiologic core activities encompass the entire state of Minnesota.

How You Can Help

  • Spread the word! Promote Bact Facts Interactive to your colleagues.
  • Provide feedback! Let us know how the website is working for you.

NHSN Updates on Long-term Care

Save the Date: 2019 NHSN LTCF Component Training

The National Healthcare Safety Network’s (NHSN) Annual Training for Long-term Care Facilities will be held from July 9-11, 2019, on the CDC campus in Atlanta, GA. The training will cover various topics such as antibiotic stewardship, data analysis, and surveillance for urinary tract infections, C. difficile, and multi-drug resistant organisms.

Long-Term Care Facility Component Annual Facility Survey

Deadline for completion of the Long-term Care Facility Component Annual Facility Survey is March 1, 2019. Check out the December 2018 LTCF Newsletter for tips in completing it.

Upcoming Webinar

There's still time! Attend the 2019 NHSN Long-term Care Facility Component webinar describing updates to the protocol.

Wednesday, February 6th, 2019 1:30-2:30pm EST

NHSN Updates on Acute Care

Save the Date: 2019 Patient Safety Component Training

The National Healthcare Safety Network's 2019 Patient Safety Component annual training is scheduled to take place March 25-29, 2019, on the CDC campus in Atlanta, GA. Registration for in-person attendance is limited to 300 participants. All presentations during the five days of the training will be available via live web stream. Continuing Education credits are pending for this activity. Stay tuned-more to come.

Patient Safety Component Annual Survey

NHSN released the 2018 Patient Safety Component (PSC) Annual Survey on January 1, 2019. This mandatory survey is completed by all facilities enrolled in the NHSN PSC to provide updated information on hospital characteristics and practices for the previous full calendar year. Please remember, surveys must be completed and submitted in NHSN by March 1, 2019. If possible, complete the survey prior to the CMS 2018 quarter 3 deadline on February 15, 2019.

Patient Safety Component – Annual Hospital Survey

Upcoming Webinars

The 2018 PSC Annual Survey will include significant updates from previous versions. NHSN will provide two webinars in early 2019 to highlight the changes made to the 2018 Patient Safety Annual Survey and cover commonly asked questions about the survey. Both webinars will present the same information, so participants can choose the date that is most convenient for them.

Thursday, January 17, 2019  2:30-3:30 p.m. EST
Thursday, February 7, 2019  2:30-3:30 p.m. EST

Information about the registering for each webinar will be sent from NHSN. For additional guidance and support, email using the words Annual Survey in the subject line to expedite the response time.

Collecting Healthcare Personnel Influenza Vaccination Data

Reporting HCP influenza vaccination in hospital outpatient departments is no longer required beginning with the 2018-2019 influenza season. Find out more about reporting requirements for acute care facilities reporting healthcare personnel (HCP) influenza vaccination summary data to NHSN. This webinar will be offered twice, and attendance is limited to 1000 participants each.

Thursday, January 24, 2019  12:30-1:30 PM EST
Tuesday, January 29, 2019  2:00-3:00 PM EST

A recording of the webinars will be posted a couple weeks after they occur at


NHSN Patient Safety Component Manual (January 2019)

The NHSN Patient Safety Component Manual is updated annually based on subject matter expert review and user feedback. Over time, certain chapters have been retired or moved to other components. To avoid confusion, the chapters in the PSC manual do not shift to account for these changes.

The additions and changes with this release are described in the NHSN v9.2 Release Notes.

CHAIN Award for Excellence: TRIA Orthopaedic Center

The Minnesota Collaborative Healthcare-Associated Infection Network (CHAIN) Award for Excellence commends the infection prevention and antibiotic stewardship efforts of health care teams working to build safer health care environments. The awards are presented annually by CHAIN. We had many great initiatives submitted, and this month we are featuring TRIA Orthopaedic Center. We hope the lessons learned will provide you with innovative ideas that are useful to you regarding infection control and antibiotic stewardship. 

TRIA Orthopaedic Center received the CHAIN Award for its preoperative Staphylococcus aureus nasal screening program.

In the summer of 2016, TRIA started a preoperative Staphylococcus aureus nasal screening program for total joint patients to reduce the number of patients colonized before surgery and thus reduce the number of surgical site infections. Approximately two months after starting the screening protocol, specimen collection compliance was noted to be only 30 percent. TRIA conducted a thorough review of collection data, including location of collection, timing of collection, and laboratory orders (including staff who entered them) to identify opportunities to improve screening.

The review showed that the majority of TRIA total joint patients were completing their history and physical appointments at providers outside of the TRIA/Park Nicollet network. Though patients were provided with a paper copy of the screening order when completing their pre-op appointment outside of network, it was not being completed.

To rectify this, all total joint patients with out-of-network providers were asked to schedule a nurse visit at TRIA to complete their pre-op screening. Additional TRIA nursing staff received training on how to collect the screening specimen to ensure the process was efficient for everyone involved. In addition, documentation templates were created in the electronic medical record to minimize time spent charting collection, education, and decolonization information. Infection prevention staff also created an algorithm for administrative assistants and nursing staff to use to determine if a patient required screening, time frame for collection, decolonization, and any necessary changes to preoperative protocols (i.e. antibiotic selection, timing, etc.) based on screening results.

Robust educational handouts were created for patients to ensure they were involved in the process. "Screening and treatment for Staphylococcus aureus before surgery" provides basic information on what Staphylococcus aureus is, why screening is important, what a positive result is, a link to MDH resources, and a table for tracking decolonization treatment for those whose screening tests are positive. All patients scheduled for a total joint procedure receive this handout.

"Preoperative nasal screening for Staphylococcus aureus at an out-of-network clinic" is given to patients who are completing their preoperative history and physical out of network, along with a paper copy of their screening order. The handout describes the importance of collection, the time frame in which the specimen should be collected, contact information to send screening results to, and what to do if the specimen cannot be collected.

TRIA leaders have been instrumental in this effort in providing adequate staffing and training resources to ensure the process flows smoothly and efficiently. To encourage compliance, the leadership team also approved a 'no charge code' for screening visits.

The screening process changes made over time have significantly increased the percentage of specimens collected from approximately 30 percent to 90 percent. The rate of total joint infections in hospital-based procedures performed by TRIA surgeons has also declined significantly.

The efforts of Abbott Northwestern Hospital, Bethany On The Lake, and TRIA Orthopaedic Center led to enhanced care delivery, patient safety, and patient experiences. CHAIN congratulates the award winners.