|
Regional Infection Prevention Teams in Action |
|
Introduction
In this section, we highlight how the VDH Regional Infection Preventionists partner with local health departments and healthcare facilities to prevent and respond to emerging infectious disease and multidrug-resistant organism (MDRO) threats in Virginia.
During the SARS-CoV-2 pandemic in 2020, when long-term care facilities (LTCFs) were hit hardest with COVID-19 morbidity and mortality, the Virginia Department of Health’s Healthcare-Associated Infections & Antimicrobial Resistance (HAI/AR) program took action. They assembled a dedicated team of Regional Infection Preventionists (IPs) to provide crucial support to these facilities. The primary objective was to safeguard the safety and well-being of both the residents and staff members in LTCFs. Throughout the pandemic response, the Regional IPs worked tirelessly alongside internal and external partners to provide statewide infection prevention training and education, subject matter expertise, and conduct individualized site visits to help strengthen facilities’ infection prevention programs.
Since then, the spread of MDROs, a silent pandemic that existed before COVID-19, has become more substantial in Virginia with increasing cases and outbreaks. Carbapenemase-producing organisms (CPOs) and Candida auris (C. auris), two emerging organisms added to the Virginia Reportable Disease List in 2018, are of extreme public health concern due to their multidrug-resistant profiles, ability to spread easily in healthcare settings, and associated morbidity and mortality. Since 2018, 993 CPO cases have been reported to VDH. The number of C. auris cases in Virginia has grown from only 3 confirmed cases prior to July 2020 to more than 230 between September 2020 and May 2023.
Antimicrobial resistance is not only a concern in Virginia but is an urgent global public health threat. Nearly five million deaths related to antimicrobial resistance occurred worldwide in 2019, according to a report released in The Lancet. To ensure that Virginia healthcare facilities are prepared to address these microbes that risk the safety of patients/residents, visitors, and healthcare personnel in the Commonwealth, the VDH Regional IPs have transitioned their efforts to actively combat and prevent MDRO threats.
|
|
Current Map of Regional Infection Preventionists by Region
|
|
Get to Know the Team
In this section, we highlight a group of staff members who have a key role in supporting the Regional IPs and share their impressions of the contributions the Regional IPs have made to their teams.
The Regional Epidemiologists are experienced, dedicated public health professionals who have a combined 117 years of tenure with the Virginia Department of Health. The Regional Epis supervise the Regional IP positions and work closely with them on outbreak investigations and infection prevention education initiatives in their regions.
-
Angela West, Central Region:
“The Central IPs collectively have more than 40 years of healthcare experience managing large infection prevention programs in medical centers. Their direct and hands-on experiences across a breadth of diseases and conditions bring such valuable knowledge and skill to our region.”
-
Ana Colón, Eastern Region
“We all know that without effective infection prevention and control it is impossible to achieve quality healthcare delivery at any level. In the Eastern Region, having two dedicated full time IPs has been an invaluable resource. Under the regional model, they can focus on working with our region’s 21 acute care and specialty hospitals, 72 nursing homes/multi-care facilities, and numerous dialysis centers, community clinics, including our local health districts. We have seen positive changes in a short period of time in the facilities. They are working along with the VDH IPs to improve their practices, respond to MDROs and other disease outbreaks. Regional IPs work collaboratively and coordinate with other regulatory agencies and healthcare partners in the region as well which has created a network of resources the facilities can utilize when needed. Our Regional IPs’ informal roles with our facilities also include problem-solving, education, sharing practical knowledge expertise, researching, mentoring, motivating and much more!”
-
Denise Sockwell, Northern Region:
“The pandemic has shown us that infection prevention and control is lacking in our long-term care facilities and other congregate settings. The facilities are challenged with recruiting and maintaining dedicated and trained staff for infection prevention and control. The Regional IPs provide skill and expertise to assist these settings by identifying areas for improvement and providing needed education and resources.” Also, the incidence of HAIs and MDROs is steadily increasing. Our Regional IPs serve as dedicated staff for assisting multiple types of facilities (acute care, long-term care, dialysis, outpatient surgery, etc.) and our local health districts with IPC recommendations. They are building capacity within the regions and Commonwealth to help minimize the impact of these infections.”
-
Patricia Bair, Northwest Region:
“Having Regional IPs has been incredibly valuable to the Northwest Region; they bring a wealth of infection control knowledge to the team as well as to our congregate living facilities. Regional IPs not only provide resources and conduct site visits with our congregate living facilities; they also provide that expertise and mentorship in infection control to staff in the VDH local health districts. Having Regional IP positions has been a much-needed resource!”
-
Paige Bordwine, Southwest Region:
“The Regional IPs provide so many services to the healthcare and residential facilities they serve. Our facilities have become comfortable with having someone to contact and get their questions answered, obtain assistance from subject matter experts, conduct educational sessions, and provide documentation for all their support.”
2023 Quarter 1 Infection Prevention Activities at a Glance
 *During a point prevalence survey, laboratory testing is used to identify individuals who are colonized with a specific organism. Body sites for colonization screening specimen collection depend on the organism being targeted.
|
|
Healthcare Setting Spotlight
In this section, we spotlight the role that the Regional IPs and other supporting team members play in one type of Virginia’s healthcare settings.
Suzanne Capps, VDH Dialysis Infection Prevention Coordinator, is one of the newest additions to the HAI/AR Program and supports the Regional IP program. She joined VDH in April 2023 and brings a wealth of experience from various roles in outpatient hemodialysis facilities. She has acquired an in-depth understanding of infection prevention challenges and best practices in the dialysis setting. In her role, Suzanne works closely with Regional IPs, conducting proactive onsite IPC assessments in dialysis facilities across Virginia. These visits aid in identifying infection prevention gaps in policy or practice and help deliver focused training to enhance dialysis staff skills.
Suzanne actively collaborates with both internal and external partners to maintain the highest infection prevention standards in dialysis settings. At the heart of Suzanne’s role is a dedication to ensuring the safety of dialysis patients and the healthcare professionals caring for them. The VDH Regional IP Program is committed to implementing patient safety initiatives aimed at mitigating HAIs and addressing emerging pathogens in the hemodialysis environment.
|
|
Collaboration Corner
In this section, we profile one of the VDH Regional IPs’ internal or external collaborators to demonstrate their partnerships and teamwork.
Similar to VDH, the Virginia Department of Social Services (DSS) has a team of infection preventionists to provide infection prevention and control education and support to adult day care facilities and assisted living facilities. The VDH Regional IPs collaborate closely with the DSS Infection Prevention and Control Team, partnering on activities such as proactive onsite infection prevention assessments, education fairs, policy reviews, and fit testing train-the-trainer events. Open lines of communication and sharing of resources and expertise between VDH and DSS help support the health and safety of residents and staff in these facilities.
|
|
Show Me The Data
Proactive Infection Prevention and Control Assessments in Dialysis Settings – Key Findings, January 2022-July 2023
In Virginia, there are 212 hemodialysis facilities. Regional IPs and the Dialysis IP Coordinator conduct proactive visits in hemodialysis facilities and assess ten IPC program domains such as hand hygiene, environmental cleaning, catheter and other vascular access care, and injection safety. Scores for each domain are calculated based on the facility’s policies, procedures, and observations made during the visit (goal=100%). These scores allow facilities to prioritize their IPC efforts internally. On a state level, VDH uses the aggregated scores to understand the IPC needs of the healthcare setting, help direct resources, and inform development of educational materials. The results from 37 proactive IPC assessments conducted between January 2022 and July 2023 demonstrate that Virginia hemodialysis facilities excelled in the categories of healthcare personnel safety and hand hygiene (Figure 1). Areas for improvement include surveillance and disease reporting, catheter and other vascular access care, respiratory hygiene/cough etiquette, and infection control program and infrastructure.
Reactive Visits in Response to Outbreaks in Healthcare Facilities, 2022Q1 and 2023Q1
Regional IPs conduct reactive onsite visits in response to reported outbreaks in healthcare facilities and other congregate settings. Reactive visits can be in response to COVID-19 or other healthcare-associated outbreaks. From 2022 to 2023, the Regional IPs conducted more than half of non-COVID-19 reactive visits in response to MDROs like C. auris and carbapenemase-producing organisms, while the rest of these visits were in response to invasive Group A Streptococcus in long-term care facilities or methicillin-resistant Staphylococcus aureus in neonatal intensive care units.
During the first quarter of 2022, nearly all reactive visits (97%) were conducted in response to COVID-19 outbreaks (Figure 2). In comparison, during the first quarter of 2023, the majority of reactive visits (59%) were for non-COVID-19 outbreaks. In addition, almost all non-COVID-19 visits (95%) occurred in the first quarter of 2023; only one visit was conducted in 2022 Q1. The difference in the type of reactive visits between the first quarters of 2022 and 2023 may be related to multiple factors including but not limited to: the decline in the number of COVID-19 cases in 2023; facilities having more experience controlling COVID-19 outbreaks and requiring less assistance from public health; and an increase in communicable disease surveillance and reporting for non-COVID-19 conditions in 2023.
|
|
Infection Prevention and Control (IPC) Resources
VDH HAI/AR Infection Prevention Website
Check out the VDH HAI/AR Infection Prevention webpage for a wealth of information and resources for healthcare facilities that address infection prevention and control topics including Standard, Transmission-Based, and Enhanced Barrier Precautions. You can also learn about and request a free, non-regulatory proactive onsite infection prevention and control assessment performed by our Regional IPs.
SHEA Compendium Updates
The Society for Healthcare Epidemiology of America (SHEA) and other partners, including the Infectious Diseases Society of America (IDSA), have updated their compendium of strategies to prevent healthcare-associated infections. These concise recommendations provide practical guidance that is divided into “essential practices” that should be adopted by all acute care hospitals and “additional approaches” that can be considered for use. The most recent compendium updates include implementation strategies to prevent infections in acute care settings (July 2023), strategies to prevent methicillin-resistant Staphylococcus aureus (June 2023) and strategies to prevent surgical site infections (May 2023). All of the updated compendium documents can be accessed on the IDSA website.
HQI Infection Prevention Resources
Virginia Infection Prevention Training Center Webinar on Proactive IPC Assessments
Looking to strengthen your infection prevention & control program? Want to make your facility even safer? Join VIPTC on September 15 at noon for a FREE webinar on VDH’s proactive infection prevention and control assessments. Learn about proactive assessments and hear first-hand accounts of onsite visits. CE credit will be offered for this webinar. Register now or visit the VIPTC website to learn more.
APIC Virginia Annual Educational Conference and Pre-Conference
Registration is open for the 2023 education conference and preconference of the Virginia chapter of the Association for Professionals in Infection Control and Epidemiology (APIC-VA). Join colleagues from around the state on October 5th (pre-conference) and 6th (conference) to discuss a variety of topics including antimicrobial stewardship, construction and renovation, water management, and infection prevention in dialysis settings. Visit APIC VA’s website to learn more about this educational opportunity.
Cuppa Tea With an IP
Every Wednesday at 2:00pm infection preventionists (IPs) can join the VDH HAI/AR Team for Cuppa Tea With an IP. This is a weekly chance to chat live with a VDH IP and subject matter experts about your infection prevention and control questions. We can’t wait to hear your questions and see how we can help.
Register once for the Cuppa Tea With an IP meetings and attend whenever you have questions or need a little IP peer boost.
For more information
Please contact: hai@vdh.virginia.gov
|
|
|
|
|
