Healthcare-Associated Infections (HAI) Update - August 2019

Minnesota Department of Health

Healthcare-Associated Infections (HAI) Update

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August 2019

In This Edition

Antibiotic Stewardship at the State Fair and One Health News Bulletin

The Minnesota One Health Antibiotic Stewardship Collaborative (MOHASC) will be available to answer questions about antibiotic use and resistance each day of the Minnesota State Fair (August 22–September 2) at a booth in the Eco Experience Building.

At 10 a.m. on Thursday, Aug. 22, an expert panel of physicians, veterinarians, and scientists will discuss how antibiotic resistance has impacted their jobs and will answer questions from the audience at the Eco Experience Sustainability Stage.

For more details about the MOHASC booth and panel discussion at the state fair, upcoming One Health events, or other antibiotic stewardship and resistance news, please read the latest Updates and News from the Minnesota One Health Antibiotic Stewardship Collaborative!

Antibiotic Stewardship Honor Roll – Bronze Level

Bronze level of MN Antibiotic Stewardship Honor Roll

The Minnesota Department of Health Healthcare-Associated Infections/Antimicrobial Resistance Section and the Minnesota One Health Antibiotic Stewardship Collaborative would like to recognize Minnesota acute care hospitals, critical access hospitals, and long-term care facilities for their commitment to antibiotic stewardship by inviting you to apply for the Minnesota Antibiotic Stewardship Honor Roll.

The Minnesota Antibiotic Stewardship Honor Rolls encourage commitment to antibiotic stewardship across the state. There are three levels of achievement, recognizing different levels of antibiotic stewardship programs. This month, ​we are highlighting the Bronze level of achievement. Bronze represents facility-wide commitment to antibiotic stewardship. It is likely that many of you have already met Bronze-level criteria within your facility. The criteria that must be met to qualify for Bronze is as follows:

  • A letter from the CEO/COO/other administrative leader that includes a statement of commitment and the names and positions of the stewardship leaders. Acute care and critical access hospitals are required to identify a physician leader and a pharmacist. Long-term care facilities are required to list the name and the position of the leader, but it does not need to be a physician or pharmacist, specifically.
  • A copy of the facility antibiotic stewardship policy.
  • A description of antibiotic stewardship education or training provided to prescribing staff and clinical caregivers that is performed at least yearly. The date of the education/training, targeted staff, and attendance rate must be provided to qualify for the Bronze level.

To apply for the Minnesota Antibiotic Stewardship Honor Roll or to view the current list of honorees, visit Minnesota Antibiotic Stewardship Honor Rolls. Please send any questions or comments you may have regarding the Honor Roll to ​

Updated Infection Prevention Recommendations for Measles

The updated CDC: Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings can help clinicians protect against the spread of measles. Measles is most commonly spread from person to person either at home or in public settings, but it can also spread in health care settings. While the most important way to prevent the spread of measles is community vaccination, core measles prevention in health care settings requires a multi-faceted approach:

  • Ensuring health care personnel have presumptive evidence of immunity to measles
  • Rapidly identifying and isolating patients with known or suspected measles
  • Adhering to Standard and Airborne Precautions for patients with known or suspected measles
  • Routinely promoting and facilitating respiratory hygiene and cough etiquette
  • Appropriately managing exposed and ill health care personnel

CDC Update on Dialysis Patient Safety

Dr. Denise Cardo, director of CDC’s Division of Healthcare Quality Promotion, detailed the work of the Making Dialysis Safer for Patients Coalition and reflected on the Coalition’s June 2019 partner meeting on CDC’s Safe Healthcare Blog this month.

There are approximately 500,000 people in the United States who rely upon dialysis treatments for advanced kidney disease. These patients are at increased risk for acquiring infections related to their health care. The Coalition’s main goal is promoting the use of CDC’s core interventions and resources to help prevent bloodstream infections in patients on dialysis.

For more information, visit CDC: Making Dialysis Safer for Patients Coalition.

CMS Payment Changes

We are in a race with superbugs. Antibiotic stewardship, along with development of new antibiotics, is needed to win the race. Centers for Medicare and Medicaid Services (CMS) payment changes are an attempt to give us a chance to keep up with the ever evolving microbes. The agency plans to modify the payment structure that undervalues antibiotics by increasing reimbursement and compensation for new antibiotics in hopes that pharmaceutical companies will invest in antibiotic development.

Learn more about the new Medicare payment policies that are being made through the CMS: Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (CMS-1716-F).

2019 South Dakota Infection Control Conference

The South Dakota Infection Control Conference is a yearly event intended to provide continuing education in infection prevention to all persons with interest in or responsibilities related to the infection control field in the state of South Dakota and the surrounding areas. The conference is on October 3-4, 2019, at the Best Western Ramkota Hotel in Sioux Falls, SD.

Registration: 2019 South Dakota Infection Control Conference

CHAIN Award for Excellence 2018 Nominees

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 hope the lessons learned will provide you with innovative ideas that are useful to you.

This month we are featuring two 2018 nominations: Lakeview Hospital and Welcov Healthcare.

Lakeview Hospital – Antibiotic Stewardship Team

Lakeview Hospital pharmacists review the patient list in Epic every shift looking for notes, appropriate antibiotic use, and duration. Feedback is given to providers at daily rounds based upon findings. The facility practices a pharmacist-driven IV to oral antibiotic transition which has increased antibiotic awareness to providers. Lakeview supports antibiotic stewardship through the transition of care by addressing duration of antibiotic use, as well as a partnership between Homecare/Hospice and the pharmacies patients use upon discharge.

Welcov Healthcare – Infection Prevention Surveillance Program

Welcov Healthcare's antibiotic stewardship program was initiated utilizing the electronic medical record (EMR). Welcov implemented a 24-hour check point for antibiotics in which floor staff perform an assessment to ensure compliance. A flow sheet to review each resident's EMR was used to track issues. A system was developed for influenza and pneumococcal vaccination compliance that had 100 percent staff compliance in 2017. The Welcov Quality Assurance and Performance Improvement Committee reviews and gives recommendations each month based on data collection and analysis.

What is CHAIN?

The Collaborative Healthcare-Associated Infections Network (CHAIN) represents a partnership formed in 2011 between the Minnesota Chapter of the Association for Professionals in Infection Control and Epidemiology (APIC-Minnesota), the Minnesota Department of Health, the Minnesota Hospital Association, and Stratis Health. In early 2017, CHAIN expanded membership to include organizations representing providers across care settings.

CHAIN coordinates across the continuum of health care delivery and supports patients, individuals, and their families to prevent harm from infections acquired in the process of care and combat antibiotic resistance.