Healthcare-Associated Infections (HAI) Update – Feb. 2020

Minnesota Department of Health

Healthcare-Associated Infections (HAI) Update

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February 2020

In This Edition

COVID-19: Supply Chain Challenges

The supply of personal protective equipment (PPE) in the United States provides sufficient product to meet the market demand, but has limited ability to rapidly increase production during public health emergencies. The Centers for Disease Control and Prevention (CDC) and Assistant Secretary for Preparedness and Response (ASPR) continue to monitor the COVID-19 situation. The Minnesota Department of Health (MDH) does not have a direct role in addressing health care supply chain challenges. MDH does not maintain caches of PPE or pharmaceuticals for distribution, or have the authority to influence supply chain manufacturers or distribution patterns.

The MDH Office of Emergency Preparedness and Response has supported the development and sustainment of eight Health Care Coalitions (HCCs) across the state for 17 years. Through the HCCs, MDH can monitor status and provide situational awareness to federal partners.

Minnesota's Health Care Coalitions: What Do They Do?

  • Promote situational awareness
  • Facilitate resource sharing/coordination
  • Facilitate information sharing
  • Facilitate coordination of incident response actions among member organizations
  • Promote efficient interface of member organizations with jurisdictional authorities
  • Support the request and receipt of assistance from local, state, and federal authorities.

If you experience supply chain challenges related to COVID-19 preparedness, please contact your regional Health Care Coalition. MDH will collate information and inform federal partners, such as CDC and ASPR, about those challenges. For more information, please visit Regional Health Care Preparedness Coordinators (RHPCs).

Suggestions for Conservation of Current PPE Stock

  • Work with your supply chain personnel. Perform inventory to determine your current supply level.
  • Assure staff use the N95s appropriately. Staff should adhere to the policy on when to wear them.
  • Dispense as needed. Have enough available for staff to use when required, but do not put all the supply out.
  • Do not put N95s on the patients.
  • Take measures to secure current stock so they are not pilfered.
  • Refer to the CDC links below to determine a course for your individual facility.

CDC Resources

MDH Resources

New High Consequence Infectious Disease (HCID) Training Videos in Toolbox

MDH has partnered with APIC Minnesota and the Minnesota Health Care Coalitions to provide ready-to-use tools for frontline facilities to prepare and respond to patients who potentially have a high consequence infectious disease (HCID). The MDH High Consequence Infectious Disease (HCID) Toolbox for Frontline Health Care Facilities website now offers two new training videos.

Check these and other videos out at Donning and Doffing Video Vignettes

PPE Level One thumbnail

Donning and Doffing PPE: HCID Level One Full Barrier Isolation

This video demonstrates how to don and doff personal protective equipment (PPE) for HCID Level One Full Barrier Isolation.

HCID Screening thumbnail

Screening for High Consequence Infectious Disease (HCID)

This video guides health care professionals through the process of identifying, isolating, and informing key partners about a patient who presents with a possible high consequence infectious disease.

HCID Workshop for EMS and First Responders

The Metro Health & Medical Preparedness Coalition is offering a free HCID workshop for EMS and first responders:

Tuesday, April 7, 2020
9:00 a.m. - 4:00 p.m.
The Commons Conference Center
655 County Road F East
Vadnais Heights, MN

Register Now: EMS HCID Workshop
Click the workshop flyer for more information!

Hands On Demonstrations:

Level 1 & Level 2 PPE donning and doffing

Transferring a patient in an IsoPod

Ambulance setup options without an IsoPod

High Consequence Infectious Disease (HCID) Workshop for EMS and First Responders


  • Discuss high consequence infectious diseases (HCID) and specific considerations for EMS.
  • Discuss considerations and options for EMS for loading and transfer of HCID patients.
  • Discuss how decontamination and waste management for HCID differ from other diseases.
  • Discuss the new multi-drug resistant organisms that make MRSA look easy.
  • Discuss real incidents and new resources available to the EMS community.

Mishandling of Injectable Medications by Health Care Workers

The Minnesota Department of Health Injection Safety Program has been a partner with CDC's One & Only Campaign for several years conducting outreach and raising awareness of safe injection practices. There is still work to be done.

In February 2020, Melissa Schaefer MD et al. published a review of patient notifications resulting from unsafe injection practices by health care personnel in the United States in a Mayo Clinic Proceedings study. From 2012 through 2018, more than 66,748 patients were notified as part of 38 patient notification events. These new data brings the total number of U.S. patients notified about potential exposure to hepatitis B or C virus or HIV because of syringe reuse or mishandling of injectable medications since 2001 to nearly 200,000. 

Injection safety is every health care provider's responsibility. One needle, one syringe, only one time! Share this article and join the injection safety listserv to stay up-to-date about the One & Only Campaign updates and CDC's efforts to reduce outbreaks associated with unsafe injection practices.

Save the Date: Annual Stewardship Conference

2020 Minnesota Antibiotic Stewardship Conference Save the Date

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)

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 Carris Health Care Center and Therapy Suites. 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.

Carris Health Care Center and Therapy Suites 

An interdisciplinary leadership team, a clinical committee, and an infection control committee discuss infection and antibiotic use information to identify trends and opportunities for improvement. This has resulted in many initiatives:

  • Antibiotic stewardship, UTI vs. asymptomatic bacteriuria, and C. difficile prevention and management education for CNAs, TMAs, LPNs, and RNs
  • Changes in standing orders and lab processes for C. difficile testing
  • Implementation of guidelines and a tool to navigate Loeb's Criteria to decrease antibiotic prescriptions for asymptomatic bacteriuria
  • A sepsis initiative to identify and react to sepsis symptoms in an efficient manner
  • Partnership with hospital pharmacy to have pharmacy review urine cultures before sending them to the prescriber to further decrease asymptomatic bacteriuria antibiotic prescriptions
  • Infection control education on a formal and informal basis for hand hygiene, antibiotic stewardship, general infection control information, and precautions recommendations
  • Involvement of staff and leadership
  • Participation in programs such as ICAR, NHSN reporting, and AHRQ Safety Program.

As a result, antibiotic use is down 42% from 2017 and 24% from 2018.

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.