Healthcare-Associated Infections Update - Jan. 2020

Minnesota Department of Health

Healthcare-Associated Infections (HAI) Update

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January 2020

In This Edition

2019 Novel Coronavirus (2019-nCoV)

We know there are a lot of questions about the 2019 novel coronavirus (2019-nCoV). The available information we have right now still suggests that the immediate health risk to the public is low. However, we consider any new infectious disease a serious concern.

Finding cases quickly and responding to them effectively is key. Fortunately, Minnesota has a strong disease surveillance system in place that includes partnerships with our hospital and clinic systems as well as local health departments.

For all Minnesotans, the best protective recommendation we can give is to take the same precautions you use to avoid colds and flu: Stay home when you are sick, cover your cough, and practice good hand washing.

Please visit our website for the latest information on the outbreak and what you can do: 2019 Novel Coronavirus (2019-nCoV).

2020 Antibiotic Stewardship Conference

2020 Minnesota Antibiotic Stewardship Conference

To be considered for a speaker and/or poster presentation, please fill out the 2020 Antibiotic Stewardship Conference Call for Speakers/Posters by February 14, 2020. Share your stewardship successes and projects with colleagues across Minnesota.

When: May 18, 2020

What: Free full-day conference focused on antibiotic stewardship

Who: For health care providers, nurses, infection preventionists, pharmacists, dental professionals, administrators, public health professionals, and others!

Where: Wilder Center, 451 Lexington Avenue North, Saint Paul, MN 55104

Save the Date: 2020 Minnesota Antibiotic Stewardship Conference (PDF)

NHSN Updates: Acute Care

It's a new decade! Time for acute care facilities to get prepared for NHSN reporting in 2020.


Webinars detailing Patient Safety Component (PSC) protocol, the annual survey, and analysis updates will be recorded and posted to the NHSN website. Please reach out to with any questions.

Register Now:
NHSN 2020 Training Webinar: PSC Analysis Update
Wednesday, February 12, 2020
12:30 – 1:30 p.m. CST

Annual Facility Survey

With the New Year, NHSN has released the 2019 Patient Safety Component (PSC) Annual Facility Survey forms along with the respective table of instructions that can now be completed within NHSN. Completion of this survey is required for all facilities enrolled in the NHSN PSC that report information on hospital characteristics and practices for the previous calendar year.

  • NHSN strongly recommends completing the survey prior to the February 18, 2020, CMS 2019 Quarter 3 deadline. Facilities that do not complete the 2019 annual survey prior to the CMS deadline will have their data risk-adjusted using the 2018 annual survey.

CDC: Patient Safety Component—Annual Hospital Survey (PDF)

Updated: Checklists

Checklists intended for use in conjunction with the 2020 Patient Safety Manual assist users with making a final determination for healthcare-associated infections. All NHSN HAI criteria for each respective module is contained in a single document. 

NHSN: HAI Checklists

Please direct any questions to

NHSN Updates: Long-term Care


Tips for completing the NHSN Annual Facility Survey for Long-term Care Facilities (LTCF) and updates for the 2020 calendar year.

Register Now: 
2020 NHSN LTCF Component Updates

Wednesday, February 5, 2020
12:30 – 1:30 p.m. CST

By Phone: 706-418-5005
Passcode: 43977287#

Annual Facility Survey

Long-term care facilities that plan to submit data in NHSN must complete the 2019 LTCF Component Annual Facility Survey prior to March 1, 2020. The survey pertains to facility characteristic and practices during January 1, 2019, through December 31, 2019.

Users are encouraged to complete the paper version of the 2019 survey form prior to entering the information into the web application because incomplete surveys cannot be saved.

CDC: Long Term Care Facility Component—Annual Facility Survey (PDF)

New: NHSN LabID Event Module Criteria Change

All positive results from specimens collected while the resident was receiving care within the LTCF must be reported. The purpose of this change is to reduce the burden on users for determining which events are considered as a reportable non-duplicate LabID event. NHSN will remove the duplicate specimens from calculated rates. Please see the updated LabID Event protocol for additional information and case scenarios.

CHAIN Award for Excellence: 2019 Nomination

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 Bethesda Hospital. We hope the work others have done will provide you with innovative ideas that are useful to you regarding patient safety and quality of care.

Bethesda Hospital (M Health Fairview)

Bethesda, a long-term acute care hospital (LTACH), offers specialized medical care for respiratory illnesses, neurovascular conditions, complex medical problems, injuries and/or physical and behavioral disabilities that require further medical interventions, and rehabilitation or behavioral management with an average length of stay more than 25 days. Patients arrive with a multitude of invasive devises; 60-75% of patients in more complex units arrive with urinary catheters. Bethesda Hospital CAUTI Team used a series of A3 projects. A3 is a structured problem solving and continuous improvement approach, using the PDCA cycle (Plan-Do-Check-Act). It looks at the problem, objectives, current state, root cause analysis, and future state.

One common issue they found was things that worked in the short-term acute care setting often needed modification in the LTACH. The Core CAUTI Workgroup consulted with experts:

  • They worked with medical records, system CAUTI A3, and providers to implement nurse-driven urinary catheter removal.
  • Guidelines for urinary catheter indications in acute care were modified for LTAC. Immobilization, wounds, I & O, and retention were defined and modified based on input from providers, nurses, pharmacists, and direct care patient staff.
  • Barriers to catheter removal were identified and alternative products considered such as education and products for patient hygiene for patients with loose stools and GI organisms. Nurses brought a pan culture order for a single temperature spike to the attention of the group. The team worked with providers to eliminate that order.
  • When a positive urine culture is identified on a catheterized patient, a yellow ticket is delivered to the unit. The unit does a "Foley" huddle to discuss questions and increase awareness.

Bethesda had a significant decrease in urinary catheter days (average of 36% for calendar year 2018 compared to average of 22% from January to June 2019).

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. By leveraging collective capacity and resources, integrating and aligning related initiatives, and breaking down silos and barriers to implementation of best practices, CHAIN serves as a resource to its members and the health care community.