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In 2022, the OHA Healthcare-Associated Infection (HAI) program set out to enhance infection prevention and control (IPC) education. In collaboration with Oregon community colleges, we worked to improve healthcare training and to support future professionals.
Our first step was assessing IPC education across 17 colleges offering healthcare degrees. Through direct conversations with program leaders, we introduced Project Firstline resources and identified gaps in IPC training. A key insight came from a Dean of Nursing, who flagged the vague IPC training requirement in Oregon Administrative Rule (OAR) 409-030.
OAR 409-030 sets standards for health professional student training. While it required “infection prevention and control practices,” it lacked clear guidance on specific IPC topics. Recognizing this gap, the HAI program collaborated with OHA’s Clinical Supports, Integration, and Workforce (CSIW) Unit to strengthen the rule.
By December 2023, the OAR was revised to require training on CDC’s Standard and Transmission-Based Precautions. In October 2024, it was further refined to specify essential IPC topics, including the use of PPE, hand hygiene, environmental cleaning, and safe injection practices.
This achievement enhances IPC education across Oregon, ensuring that our healthcare students receive standardized, high-quality training. Our work was highlighted nationally at CDC’s Project Firstline Office Hours (January 2024) and the National Association of County and City Health Officials (NACCHO)’s Local Infection Prevention Summit (May 2024).
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The hospital HAI dashboard has been updated to include 2023 data. This updated dashboard shows progress in reducing healthcare-associated infections in Oregon hospitals, including for Clostridioides Difficile infection, which causes an estimated 30,000 deaths nationwide.
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Need infection prevention support? Our experienced Infection Preventionists are here to help! Our team can offer expert guidance if you're managing an outbreak or looking to strengthen your infection prevention practices. Reach out for a consultation, and let us help you keep patients and staff safe!
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Update: Oregon carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) cases through December 2024 can be found in the CRE Quarterly Report.
Bar graph showing increasing trend of CP-CRE, 2010-2024
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Monthly Oregon IP Collaboratives Sign up to enhance your infection prevention knowledge and stay ahead in protecting patients, residents, and staff. Reach out if you're interested in joining our Eastern or Western Oregon IP Collaboratives, where we spend one hour a month discussing the latest infection prevention strategies. All interested healthcare and public health staff are welcome to attend.
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Oregon Long-term Care Facility Antibiotic Stewardship Learning Series Sign up for a one-hour monthly training on best practices for antibiotic stewardship in nursing, assisted living, and residential care facilities. Sessions will take place on the fourth Wednesday of each month beginning April 23, and participants who complete all six sessions will receive a certificate of completion. To sign up, contact Ryan Frick, Population Health Epidemiologist.
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This Earth Day (April 22), healthcare providers are encouraged to reduce the environmental burden of antibiotics and protect both human and environmental health. While antimicrobial resistance (AMR) is widely recognized as a serious issue in healthcare settings, emerging research highlights the role of antibiotic pollution as a driver of AMR. It raises concerns about the environmental impacts of antibiotic use.
- A recent study explored the link between unnecessary antibiotics and greenhouse gas emissions. Researchers estimated that of the 236 million outpatient antibiotic prescriptions in 2022, roughly 66 million were unnecessary, resulting in 1,887.374 tons of carbon dioxide emission equivalents—equal to driving 4.8 million miles in an average gas-powered car.
- Globally, rivers carry up to 2 million metric tons of plastic debris to oceans annually. A recent study found that plastic pollution in waterways harbors opportunistic "microbial hitchhikers" such as Pseudomonas aeruginosa and Acinetobacter baumannii, along with antibiotic resistance genes. Researchers warn that plastics could act as a reservoir for antibiotic resistance.
- Flowing into wastewater treatment plants is a brew containing antibiotic-resistant bacteria, AMR genes, and antimicrobial drug residues from farms, households, and healthcare facilities. While wastewater treatment reduces the levels of resistant pathogens, it cannot eliminate them. When treated wastewater is discharged into rivers and surface waters, resistant pathogens and antimicrobial resistance (AMR) genes can be transmitted to animals, enter the food chain, or infect humans. The extent of transmission and its impact on humans and animals remains largely unknown. Oregon State University, with support from the U.S. Environmental Protection Agency (EPA), is studying wastewater and sewage treatment systems to enhance our understanding of the role of wastewater in the spread of AMR in the environment.
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Are you ready for the infection control challenge? Click Next to find out.
¿Está preparado para el reto del control de infecciones? Seleccione el botón para comenzar.
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- A survey of hospitals in Ontario, Canada, reveals that the incidence of carbapenemase-producing organisms (CPOs) doubled from 2022 to 2023.
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Superbugs on the Rise: How Diabetes Fuels the Evolution of Antibiotic Resistance
- Drugmaker AbbVie announced that the U.S. Food and Drug Administration (FDA) has approved Emblaveo (aztreonam-avibactam) for treating complicated intra-abdominal infections (cIAIs).
- Antibiotic prescribing for COVID-19 and other viral acute respiratory tract infections (ARTIs) remained higher than it should be. Overall, 45.8% of COVID-19 admissions and 51.2% of viral ARTI admissions received at least one dose of antibiotic from March 2020 through December 2023.
- A cohort study of hospitalized patients found that demographics and rurality have an impact on healthcare-associated infection (HAI) risk and outcomes.
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AHRQ Safety Program for Healthcare-Associated Infection (HAI) Prevention: CLABSI. This 9-month program will support acute care hospital units in implementing strategies to reduce central-line-associated bloodstream infection (CLABSI) rates. Through this free program, participating units can strengthen their team-based infection prevention practices and earn continuing medical education (CME) and continuing education unit (CEU) credits. The program is currently recruiting adult hospital intensive care units (ICUs) and non-ICUs for this program, slated to start in July 2025. Register for an informational webinar.
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World Immunization Week, April 24-30, aims to highlight the collective action needed and to promote the use of vaccines to protect all people against disease. Through its convening power, the World Health Organization (WHO) works with countries across the globe to:
- raise awareness of the value of vaccines and immunization, and
- ensures that governments obtain the necessary guidance and technical support to implement high-quality immunization programs.
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Get to know the exceptional members of the HAI team.
Heather Hertzel is the Emerging Infections Program (EIP) multidrug-resistant organism (MDRO) Epidemiologist. Alongside fellow MDRO Epidemiologist Evelyn Donahoe, she provides state-level surveillance, response, and support to local public health agencies for MDRO pathogens such as carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Acinetobacter (CRA), Candida auris, and carbapenemase-producing organisms (CPOs). Heather also serves as the surveillance officer for the Multi-site Gram-negative Surveillance Initiative (MuGSI), a national surveillance project focused on CRE and CRA in various regions, including the Portland metro area. This involves conducting detailed chart reviews to identify risk factors and track disease trends. She advocated for making CRA a reportable condition statewide and was the lead epidemiologist on Oregon’s first C. auris outbreak in 2021.
Heather holds degrees in Microbiology and Global Health from Arizona State University and earned her Master of Public Health at the University of Wisconsin–La Crosse. Before joining the Oregon HAI team in 2020, she tried a little bit of everything in public health, working in emergency preparedness, immunizations, and reproductive health, and for organizations including local health departments, non-profits, and the CDC.
When she’s not putting together the quarterly CRE report, Heather enjoys oil painting, ice skating, a good sci-fi/fantasy novel, hot tubs, and introducing her 16-year-old niece to Buffy the Vampire Slayer. As a lover of the outdoors and a bit of a worrier, Heather finds comfort and inspiration in Mary Oliver’s poem Wild Geese. She and her fiancé Keith are excited to get married this summer at a beautiful Portland park.
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Healthcare providers can play a significant role in reducing the environmental impact of antibiotics through responsible prescribing and promoting proper disposal practices.
Antibiotic Stewardship: Providers should prescribe antibiotics only when necessary, at the correct dose, and for the correct duration.
- Integrate evidence-based guidelines into clinical practice.
- Use proper diagnostics, like point-of-care testing, to ensure antibiotics are prescribed only when needed.
- Avoid broad-spectrum antibiotics when narrow-spectrum alternatives are available.
Proper Disposal of Antibiotics: Improper disposal of antibiotics—by flushing them down drains, toilets, or throwing them in the trash—can lead to environmental contamination through wastewater systems.
- Ensure your facility has protocols in place to prevent antibiotics from entering municipal wastewater systems and follow best practices for disposing of pharmaceutical waste.
- Educate patients about the importance of returning unused medications to designated take-back locations, which are set up to dispose of pharmaceuticals safely. Patients can find collections sites at org or request a free envelope to mail in prescription medications for disposal.
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Oregon Health Authority works to transform the health care system in Oregon by lowering and containing costs, improving quality and increasing access to care to improve the lifelong health of Oregonians. OHA is overseen by the nine-member citizen Oregon Health Policy Board working toward comprehensive health reform in our state.
The HAI program within the OHA Public Health Division is dedicated to preventing and containing healthcare associated infections (HAIs) and addressing the growing challenge of antimicrobial resistance (AR). Through initiatives such as the Antimicrobial Resistance Laboratory Network (AR Lab Network) and the National Healthcare Safety Network (NHSN), we are bolstering our ability to detect and respond to antibiotic resistance while strengthening the nation's most widely used HAI tracking system. We also focus on antibiotic stewardship to improve the appropriate use of antibiotics, and we provide comprehensive infection prevention and control (IPC) education and training to equip the health care workforce with the necessary skills. Our team further offers IPC consultations to health care facilities throughout the state, providing expert guidance and support in implementing effective infection prevention strategies and responding to outbreaks. Together, we are committed to enhancing patient safety and reducing the impact of HAIs and antimicrobial resistance.
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