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Regional Infection Prevention Teams in Action |
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Introduction
In this section, we highlight how the Virginia Department of Health (VDH) Regional Infection Preventionists partner with healthcare facilities to enhance infection prevention and control infrastructure in the Commonwealth.
Staff shortages and high turnover rates exacerbated by the COVID-19 pandemic caused challenges with maintaining strong infection prevention and control (IPC) programs in healthcare facilities, especially in long-term care (LTC) and hemodialysis settings. The VDH Healthcare-Associated Infections and Antimicrobial Resistance Program’s Regional Infection Preventionists (IPs) have played a pivotal role supporting IPC programs and their IPs in impacted facilities by using innovative and active solutions. One example is conducting proactive infection prevention assessments. Through these assessments, they help the facility identify strengths and gaps in IPC practices and assess healthcare personnel adherence to and understanding of those practices. The VDH Regional Infection Preventionists provide ongoing support to help facilities by:
- Sharing evidence-based practices and IPC resources tailored to facility needs
- Conducting IPC education and training
- Mentoring healthcare facility staff assigned to IPC program activities
- Working closely with facility administrators and corporate leaders
With this collaborative work counteracting IPC challenges faced by healthcare facilities, the Regional IPs are continuing to advance the VDH mission to protect the health and promote the well-being of all people in Virginia, including those in healthcare facilities.
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Current Map of Regional Infection Preventionists by Region
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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.
Angela Spleen, PhD is the Infection Prevention and Control Program Manager. She has 11 years of experience as a public health scientist, including four years in various roles within the VDH HAI/AR Program.
Suzanne Capps, RN, a-IPC is the Dialysis Infection Prevention Coordinator who is responsible for improving infection prevention and control practices within Virginia outpatient hemodialysis facilities. She has eight years of dialysis experience and has held various positions in outpatient hemodialysis facilities.
VDH Central Office has two Regional Infection Prevention Coordinators who provide guidance and technical assistance to the Regional IP teams and collaborate with them to support infection prevention needs of healthcare facilities, local health departments, and liaise with statewide partner organizations.
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Andrea Chapman, MPH, CHOP, CIC is the Regional Infection Prevention Coordinator who primarily supports the Regional IP teams in Central, Eastern, and Northern Regions. She has 14 years of experience in infection prevention and healthcare epidemiology, including five years as an infection preventionist in an acute care hospital and nine years serving in various roles in the VDH HAI/AR Program.
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Carolyn Kiefer, RN, MSN, CIC, FAPIC is the Regional Infection Prevention Coordinator who primarily supports the Regional IP teams in Northwest and Southwest Regions. She has 19 years of experience, 12 of which are in infection control. She has been in infection prevention roles across the continuum of care, including acute care, long-term care, and outpatient settings.
Laura Robertson is the Administrative Assistant for the HAI/AR Program. Previously, she worked with VDH as a COVID-19 Case investigator. Laura has an undergraduate degree in Health Science and is currently finishing a certification in Health Behavior Coaching at VCU.
2023 Quarter 2 Infection Prevention Activities at a Glance
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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.
VDH Regional IPs frequently partner with healthcare facilities, especially long-term care facilities, by conducting infection prevention education fairs for healthcare personnel. Often, the education is part of a follow-up from a recent proactive or reactive infection prevention assessment, demonstrating VDH’s ongoing collaboration with the facility to support their IPC programs. These sessions are tailored to the facility, targeting specific staff roles (e.g., environmental services) as needed and usually focus on core infection prevention practices such as hand hygiene, personal protective equipment, and environmental cleaning and disinfection.
From January to October 2023, the Regional IPs participated in 19 education fairs in long-term care facilities (three in assisted living settings, 16 in nursing homes). More than 600 facility staff received IPC education during these events.
Facilities interested in printing their own posters for education fairs or other staff education initiatives can find standardized resources on the HAI/AR Education & Training webpage (see “Education Fair Posters on Core Infection Prevention Strategies” under “Infection Prevention Resources”).
Healthcare settings may request assistance with infection prevention education at their facility by contacting hai@vdh.virginia.gov.
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Collaboration Corner
In this section, we profile one of the VDH Regional IPs’ internal or external collaborations to demonstrate their partnerships and teamwork.
Annually, the HAI/AR Program collaborates with the Virginia chapter of the Association for Professionals in Infection Control and Epidemiology (APIC-VA) for their fall educational conference. This year for the 48th annual conference, Carolyn Kiefer, Regional IP Coordinator, served as co-chair. Other HAI/AR team members (Ginger Vanhoozer, Yeo-Jin Lee, Emily Hawker, and Suzanne Capps) and several Regional Infection Preventionists (Marsha Kemp, Brandon Sutton, and Ann Seidel) took part in the conference and hosted a VDH table to provide IPC resources and support to partners.
 From left to right, back: Marsha Kemp, Carolyn Kiefer, Ginger Vanhoozer, Yeo-Jin Lee, Brandon Sutton. Front: Emily Hawker, Ann Seidel, Suzanne Capps.
Ginger Vanhoozer, Infection Prevention Educator, and Marsha Kemp and Wendy Fariss, Central Region IPs, submitted posters for their collaborative IPC work. Ginger’s Infection Prevention Educator Roadshow was awarded “Best Training Session / Most Innovative Education Program”. Wendy and Marsha’s Candida auris: Central Region IP Response was awarded “Best Poster Overall”.
Marsha and Wendy’s poster detailed their response to an increase of Candida auris (C. auris) cases in the Central Region. Through the collaborative investigation with the local health department (LHD) and facility representatives, chart reviews and point prevalence surveys were conducted that identified additional colonized cases at the initial facility. They also identified three other facilities connected with the initial through resident transfer relationships. Screening at these facilities found additional cases.
In response, Marsha and Wendy, in collaboration with the LHD, conducted site visits at each of the facilities, developed a C. auris education booklet for healthcare facilities, and provided education in a variety of formats to meet facility needs. This work showcased successful close collaboration between the Central Region IP team, other public health colleagues within LHDs, and healthcare facilities across the continuum of care.
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Show Me The Data
Proactive Infection Prevention and Control Assessments in Outpatient Settings – Key Findings, January 2022 - November 2023
In Virginia, there are hundreds of outpatient facilities. Regional IPs conduct proactive visits in outpatient clinics (e.g., free clinics, medical, dental, and orthopedic surgical offices) and assess ten IPC program domains:
- infection control program infrastructure
- healthcare personnel training and competency
- healthcare personnel safety
- surveillance and disease reporting
- hand hygiene
- personal protective equipment (PPE)
- respiratory hygiene
- environmental cleaning and disinfection
- injection safety
- device reprocessing
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 22 proactive IPC assessments conducted between January 2022 and November 2023 in Virginia outpatient settings demonstrate that facilities excelled in the categories of surveillance and disease reporting, respiratory hygiene and cough etiquette, and infection control program and infrastructure (Figure 1). Areas for improvement include PPE, hand hygiene, device reprocessing, and environmental cleaning.
Group A Streptococcus Outbreaks in Virginia’s Healthcare Facilities
Group A Streptococcus (Streptococcus pyogenes) bacteria are commonly found in the throat and on the skin. Group A Strep (also known as GAS) can cause a wide range of infections from minor (e.g., strep throat, superficial skin infections) to serious (e.g., invasive infections, necrotizing fasciitis). The overall case-fatality rate for invasive GAS is estimated to be 10-15%. GAS is highly communicable, particularly in congregate care settings. Compared to age-matched adults living in the community, residents of long-term care facilities have a 3- to 8-fold higher incidence of invasive GAS infections and are 1.5 times more likely to die from GAS infections.
In Virginia, a GAS outbreak is defined as two or more persons with invasive GAS infection with the same exposure clustered in space and time. However, one invasive case in a resident of a congregate care facility should be reported and investigated. Figure 2 shows the number of invasive GAS outbreaks in healthcare settings reported to VDH from January 2018 to November 2023. Long-term care facilities accounted for 85% of all invasive GAS healthcare outbreaks during this time period. Of note, 2023 has observed a substantial increase in the number of reported invasive GAS outbreaks.
Poor infection prevention practices usually lead to continuous GAS transmission and prolonged outbreaks. To prevent and mitigate outbreaks, IPC programs must address work exclusions for ill staff, hand hygiene, personal protective equipment, cleaning and disinfection of environmental surfaces and reusable equipment, wound care, and respiratory care practices. Regional IPs have a role in responding to these outbreaks in partnership with local health departments by conducting site visits, making observations, and sharing recommendations on how to improve IPC practices.
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Infection Prevention and Control (IPC) Resources
Candida auris Education Booklet for Healthcare Facilities
VDH has published a comprehensive education booklet to help healthcare facilities take proactive steps when a case of C. auris has been identified. This resource includes information on infection prevention strategies, interfacility communication, and how to work with the health department.
Candida auris Patient Education Resource
VDH published a new trifold brochure that healthcare facilities can use to educate patients who have C. auris. This brochure focuses on living with C. auris and actions to prevent the spread of the organism.
Environmental Cleaning and Disinfection Responsibilities Checklist
VDH created an editable template for healthcare facilities to define key high-touch surfaces and medical equipment, which department/discipline is primarily responsible for the cleaning, the frequency, and what product is to be used.
Quick Guides for Nursing Home Infection Preventionists (IPs)
These resources address topics such as organisms that may be seen in nursing homes (e.g., Candida auris, COVID-19, Group A Strep) and infection prevention strategies (e.g., Enhanced Barrier Precautions, cleaning and disinfection) and cover key concepts and action items on each topic, including how to educate residents and staff. Find the quick guides on the VDH Infection Prevention in Long-Term Care Settings webpage (see “Hot Topics”).
Safe Blood Glucose Checks
VDH published a new one-page educational resource that provides staff with infection prevention reminders on how to safely perform blood glucose checks on patients/residents.
Virginia Infection Prevention Training Center (VIPTC): New Resources
The latest IPC resources posted by VIPTC include: (1) training videos on topics such as the chain of transmission, chlorhexidine treatments, Contact Precautions, hand hygiene, sterile surgical instrument peel packs, and universal masking; and (2) a course on infection prevention and control strategies in pediatric settings.
Virginia Infection Prevention Training Center Webinar: VDH Proactive Infection Prevention and Control Assessments
VDH recently partnered with VIPTC to talk about proactive infection prevention and control assessments and how VDH partners with healthcare facilities before, during, and after these onsite visits. The webinar can be viewed on demand on VIPTC’s website.
Wound Care Infection Prevention and Control Tool
Need any refreshers about basic wound care IPC practices to make sure your policies and procedures are comprehensive? The new VDH wound care IPC tool is now online and helps healthcare facilities ensure wound care is done safely to reduce the risk of infection transmission.
Check out the Virginia Infection Prevention and Control Training Alliance’s Events Calendar for upcoming IPC education opportunities!
For more information
Please contact: hai@vdh.virginia.gov
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