UPCOMING WEBINARS AND

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Healthcare Guidance Update

The WA State Department of Health (DOH) has updated the Interim Recommendations for SARS-CoV-2 Infection Prevention and Control in Healthcare Settings. Updates can be found at the COVID-19 Infection Prevention in Health Care Settings web page.

Please tune in on Thursday April 20, 2023, from 10:00 -11:30 AM for a follow-up to the April 6th webinar to review Frequently Asked Questions and additional subject matter expert presentations related to the updated guidance. Contact HAI-COVID@doh.wa.gov with any additional questions.

April 20th, 10 AM PST • Register

DOH Staffing Chat: How do we keep you in long-term care?"

The Healthcare-Associated Infections and Antimicrobial Resistance Section is conducting “Staffing Chat: How do we keep you in long-term care?” focus groups to address the turnover rate in long-term care (LTC) staffing. Turnover in LTC staff has been shown to impact the burden of healthcare-associated infections. This will be a 45-minute online focus group for direct patient care staff (CNA, Home Care Aide, LPN, RN, and more) working in Washington state LTC facilities, with the goal to provide suggestions for facilities to improve staff retention.

HAI Staffing Chat Flyer

April 19th, 4 PM PST • RSVP

April 26th, 10 AM PST • RSVP

Navigating Infection Control Training Requirements in ​Long-Term Care

Marburg Virus Disease Outbreaks in Equatorial Guinea and Tanzania

Division of Healthcare Quality Promotion would like to highlight a Health Advisory Network (HAN) release which was published April 6th due to ongoing outbreaks of Marburg virus disease (MVD) in Equatorial Guinea and Tanzania. The HAN includes recommendations for clinicians, public health departments, clinical laboratory biosafety, and the public. The following infection prevention and control measures are included in the HAN:

Infection Prevention and Control Measures In hospitals, CDC recommends a combination of infection prevention and control measures to prevent transmission of MVD. These infection prevention and control measures include personal protective equipment (PPE), patient placement, and patient care considerations. If MVD is suspected, patients should be isolated in a private room with a private bathroom or covered bedside toilet. Healthcare personnel should follow the same infection prevention and control measures as recommended for Ebola disease, including using recommended personal protective equipment (PPE) and limiting the number of personnel who enter the room for clinical evaluation and management.

Healthcare personnel can be exposed through contact with a patient’s body fluids, contaminated medical supplies and equipment, or contaminated environmental surfaces. Splashes to unprotected mucous membranes (e.g., the eyes, nose, or mouth) are particularly hazardous. Procedures that can increase environmental contamination with infectious material, involve handling of potentially contaminated needles or other sharps, or create aerosols should be minimized. Separate PPE guidance is available for managing clinically stable and clinically unstable patients.

The following infection prevention resources are also available in the HAN:

• Interim Guidance for U.S. Hospital Preparedness for Patients Under Investigation (PUIs) or with Confirmed Ebola Virus Disease.
• Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (MVD) in U.S. Hospitals.
• Personal Protective Equipment (PPE) | Public Health Planners | Ebola (Ebola Virus Disease) | CDC Cleaning and disinfecting.
• Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus.
• Guidance for U.S. Hospitals and Clinical Laboratories on Performing Routine Diagnostic Testing for Patients with Suspected Marburg Virus Disease | CDC.
• Procedures for Safe Handling and Management of Ebola-Associated Waste.

The 2022 Annual ICAR Report

During 2022, the Washington State Department of Healthcare Associated Infection and Antimicrobial Resistance Section (HAI/AR) worked alongside Local Health Jurisdictions (LHJs) to conduct 831 Infection Control Assessment and Response (ICAR) consultations in healthcare facilities, the majority were in Long-term Care (LTC) settings. In addition to LTC, we supported hospitals, supported living services, behavioral health, and outpatient clinics with their infection prevention and control (IPC) needs.

The primary focus was to promote long-term relationship building between public health and LTC, and support sustained healthcare IPC practices.

• Conducted a facility-level engagement survey to gain a stronger understanding of which IPC topics are most helpful during the consultations.
• Facility-level feedback was vital as it allowed us to incorporate feedback and suggestions into future ICAR consultations.
• Continued to maintain additional efforts towards the importance of onsite consultations.
• Continuing on-site ICARs allowed us to take a hands-on approach alongside the LHJs to offer resources and support to facilities.

Clinical Pearls:

Penicillin Allergy Article

• There are data showing that penicillin and other beta-lactam allergies are associated with several unwanted effects, including increased odds of C. difficile infection & increased odds of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection.
• This article written by the Antimicrobial Stewardship Team contains more statistics & information on this important patient safety topic, as well as links to resources to support facilities in their penicillin allergy delabeling journey.
• Read more.

Medical Providers’ Frequently Asked Questions About Urinary Tract Infections (UTI): Evidence for Safe Management of Suspected UTIs

• This is a document designed to provide an evidence-based perspective on some common concerns that factor into antibiotic prescribing for asymptomatic bacteriuria.
• This is one of many support strategies that we are working on to support stewardship in the state of WA. We hope that you will find this resource valuable.
• Read more.

Study: Antibiotics don't reduce risk of death from viral respiratory infections

• This study included 2,111 adult patients who tested positive on admission for respiratory syncytial virus (RSV), influenza, and COVID-19. Nearly 2/3rds received antibiotics but did not appear to benefit from them. Read more.

Educational Opportunities:

Skilled Nursing Facility Antimicrobial Stewardship Collaborative

• The Washington State Department of Health is hosting an antimicrobial stewardship collaborative that will start in June and last for 1 year. The goal of this collaborative is to assist facilities in progressing towards meeting the Centers for Medicare and Medicaid mandates and Centers for Disease Control's Core Elements of Antibiotic Stewardship for Nursing Homes. Participation in the collaborative is voluntary, but participating facilities can earn an incentive of up to $5,000 by completing specific activities. Learn more & Register.

Reminders:

NHSN Antibiotic Use and Resistance (AUR) Module Reporting Requirement for Hospitals

• CDC's National Healthcare Safety Network (NHSN) Antimicrobial Use and Resistance (AUR) Module is the primary surveillance system for tracking antimicrobial use in all US hospitals. All hospitals will be required by Centers for Medicare and Medicaid Services (CMS) to be in “Active Engagement” in NHSN AUR module starting in 2024.  We put together a Frequently Asked Questions document to help you get started.

NHSN Antimicrobial Use (AU) Module Reporting Funding Opportunity for Hospitals

• To help offset the cost of implementing reporting to the NHSN-AU module, the Department of Health is offering $5,000 financial reimbursement to hospitals that start reporting to the NHSN-AUR module between August 1st, 2022, and March 1st, 2024.  Learn more and apply for funding.

Project Firstline is a nationwide project supported by the CDC and the Washington State Department of Health to provide frontline healthcare workers with infection prevention and control education.

Reduce the Spread of Infection - Become an Infection Control Superhero with the Washington State Project Firstline Learning Modules

The six-module series is based on CDC Project Firstline contend and focuses on the following:

Modules are available at firstline.nwcphp.org. 

We encourage you to print the attached flyer and post it in your breakroom for your staff.

Washington Project Firstline Promotional Flyer

Facility Program: Frontline Infection Prevention Champion

Become a Frontline Infection Prevention Champion Facility! Qualification: 90% frontline staff completes all 6 WA Project Firstline training modules. Steps: Request a Facility Code Have your staff members enter Facility Code in user profile. Notify staff to complete all six modules – they will receive 2 (free) contact hours of CEs/CNEs. Once 90% of your staff complete all 6 training modules, you will be recognized as a Frontline Infection Prevention Champion facility.

Are you unsure how close you are to 90%? Email Project Firstline to verify.

You will receive a certificate and recognition on Washington Project Firstline webpage. Most importantly, your staff will be trained in infection prevention!

*NEW* Spanish Interactive Resources 

Check out the Spanish Resources on the Project Firstline website for some new interactive resources on the following pages: 

Sobre el Proyecto Firstline 

Acceda a los materials educativos sobre el control de infecciones 

The Project Firstline Podcast, hosted by the Washington State Department of Health, is geared toward frontline healthcare workers to bring awareness to infection prevention and public health practices. We identify the importance and impact of infection prevention on our lives and on the lives of our community. RECENT EPISODES Surveillance in Public Health & Healthcare Respiratory Protection Vaccine Preventable Diseases (VPDs)  Dental Settings

NEW Episode:

Catch up on previous episodes:

Tune in the first Thursday of each month for new episodes

____________________________________________

#20 Using Creativity to Make a Hand Hygiene Observer Program Effective

#19 Factors that influence depression, anxiety, and burnout: Workplace wellness support makes a difference for Infection Preventionists.

#18 Does C. diff in previous room occupants predict C. diff in subsequent room occupants?

#17 Assessing Infection Preventionist (IP) Roles in Non-Acute Care Settings

What is a Respiratory Protection Program? 

A Respiratory Protection Program (RPP) is a set of rules and regulations enforced by the Washington State Department of Labor and Industries (L&I). These rules and regulations are in place to keep workers from becoming sick or injured because of workplace exposures to hazards. One significant hazard comes from viruses that spread through the air when a sick or contagious person coughs, talks or sneezes. Spreading viruses through the air is a respiratory hazard. Read more.

The DOH Occupational Health Team is hosting monthly 30-minute, Lunch & Learn sessions on specific respiratory protection topics. Bring your topic questions to the session or email them ahead of time to HAI-FitTest@doh.wa.gov.

Sessions start promptly at 12:00 PM

• April 19^th – Who should be in the Respiratory Protection Program?
• May 17^th – Estimating what shape N95 likely to work for people’s faces
• June 21^st – Tips for the Respirator Program Administrator
• July 19^th – Tips for the employee respirator training

For more information contact Stella Daniels, Occupational Health Team Supervisor.

Learn how to conduct your own fit test.

Join us for a 1-hour review of the fit test equipment and see how a valid fit test is done. Visit our website for detailed information.

• Monday, April 24th, 3 PM
• Tuesday, May 9th, 1 PM
• Thursday, May 25th, 11 AM
• Wednesday, June 7th, 3 PM
• Monday, June 26th, 11 AM
• Monday, July 10th, 11 AM
• Wednesday, July 26th,1 PM

Quarterly NHSN User Group for Hospitals

*Calls are facilitated through TEAMS*

Please contact Sandy Ng for a TEAMS invitation

All sessions are from 10:30 - 11:30 AM  

July 11, 2023

October 10, 2023

Monthly LTC NHSN User Group

This is monthly forum for NHSN skilled nursing facilities (SNFs) to share and collaborate, improve reporting accuracy, and increase user knowledge.

Please contact Paula Parsons for more information

Calls scheduled 2^nd Thursday of the month, 11:00 AM - 12:00 PM

Upcoming dates:

May 11, 2023

June 8, 2023

July 13, 2023

August 10, 2023

September 14, 2023

Covering the nose and mouth had been part of traditional sanitary practices against contagious diseases in early modern Europe.  Face masks, as they are used today in health care and in the community, can be largely traced back historically to a more recent period when a new understanding of contagion based on germ theory was applied to surgery.

Outbreaks of SARS-CoV-2 Infections in Nursing Homes during Periods of Delta and Omicron Predominance, United States, July 2021–March 2022

SARS-CoV-2 infections among vaccinated nursing home residents increased after the Omicron variant emerged. Data on booster dose effectiveness in this population are limited. During July 2021–March 2022, nursing home outbreaks in 11 US jurisdictions involving >3 infections within 14 days among residents who had received at least the primary COVID-19 vaccine(s) were monitored. Among 2,188 nursing homes, 1,247 outbreaks were reported in the periods of Delta (n = 356, 29%), mixed Delta/Omicron (n = 354, 28%), and Omicron (n = 536, 43%) predominance. During the Omicron-predominant period, the risk for infection within 14 days of an outbreak start was lower among boosted residents than among residents who had received the primary vaccine series alone (risk ratio [RR] 0.25, 95% CI 0.19–0.33). Once infected, boosted residents were at lower risk for all-cause hospitalization (RR 0.48, 95% CI 0.40–0.49) and death (RR 0.45, 95% CI 0.34–0.59) than primary vaccine–only residents. Read more. 

Lori Nerbonne, of New England Patient Voices, discusses how patients and families can improve patient safety

To help celebrate Patient Safety Awareness Week, CDC has published a new patient safety blog. Lori Nerbonne, cofounder of New England Patient Voices, shares her experience as a patient safety advocate, which began after the death of her mother in 2004. She discusses the importance of patient engagement and shares patient safety tips and tools from infection preventionist Marie Moss. Read more.

How U.S. officials cracked mystery of eyedrops that blinded people across country

Experts marvel at how disease detectives pieced together the case: Patients were scattered across the country. The illnesses occurred over the span of months. The infections were found in different parts of the body — in the blood of some patients, in the lungs of others. Read more. 

Extending outbreak investigation with machine learning and graph theory: Benefits of new tools with application to a nosocomial outbreak of a multidrug-resistant organism

From January 1, 2018, until July 31, 2020, a hospital network in Switzerland experienced an outbreak of vancomycin-resistant enterococci (VRE). The goal of their study was to improve existing processes by applying machine-learning and graph-theoretical methods to a nosocomial outbreak investigation. Risk factors for being a VRE carrier were identified, along with 3 important links with VRE (healthcare personnel, medical devices, patient rooms). The author concludes that data science is likely to provide a better understanding of outbreaks, but interpretations require data maturity, and potential confounding factors must be considered. Infection Control & Hospital Epidemiology, March 7, 2023. Read more. 

Request for Special Pathogens Preparedness Assistance

If your organization would like to request support, please follow this process: Determine education and/or training needs. Send a brief outline of identified needs and potential timeline to christina.arguinchona@providence.org Christa to schedule a 30-minute virtual meeting to discuss next steps.

SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update

The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. Read more. 

WA One Health Conference – Save the Date & Call for Abstracts

This year’s Washington One Health Conference will be held on August 16^th at Central Washington University in Ellensburg. This all-day event will feature topics at the human, animal, and environmental interface. While in-person participation is encouraged, we will also have a virtual option for attendance. 

We are currently accepting abstracts for consideration for this conference. If you are interested to present, please submit your abstract by 5/12/2023. Your abstract must be 400 words or less and be pertinent to our One Health theme. All presenters should plan to attend in-person.

Additional information regarding the conference will be posted on the conference webpage. We will send an additional notification when registration is opened. For more information, or if you are interested in joining the planning committee, reach out to Lauren Sarkissian.

CDC Safe Healthcare Blog | Patient Engagement in Infection Prevention

This blog is a part of a series that CDC launched to highlight the importance of patient safety by providing educational information and simple ways to help people stay informed on public safety topics. Visit the webpage to read the latest blog authored by Lori Nerbonne and Marie K. Moss about the importance of patient engagement in infection prevention.

Information required for continuation of Nurse Aide Waiver

If you completed this survey last month, please complete this survey again.  We are required to compile this information and send it to CMS on a monthly basis.

*ATTENTION NURSING HOMES*

To remain in compliance with the Nurse Aide 1135 waiver, Washington State is required to provide CMS monthly reports.  As a part of the report process the state needs to compile information from each CMS certified nursing home on a monthly basis. Please assist in this process by completing the 3 question survey. If we are unable to provide the requested information to CMS, Washington state may lose this critically important 1135 waiver and the ability to allow NARs to continue working in a nursing home beyond 4 months while they complete the certification process.

CMS Memo: Strengthened Enhanced Enforcement for Infection Control Deficiencies and QI Activities in LTPACs

The revised guidance strengthens enforcement efforts for noncompliance with infection control deficiencies, particularly those that result in actual harm or immediate jeopardy to residents. Read more.

A letter to Providers/Administrators/Superintendents regarding the following topic is now available online:

• Secretary of Health Face Covering Order Ends April 3, 2023

A letter to NH Administrators regarding the following topics are now available online:

• Discontinuing Discretionary Tasks and Resuming Mandatory Facility Tasks in the Long-Term Care Survey Process 

A letter to ALF Administrators regarding the following topic is now available online:

• Qualified Assessor

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