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 Healthcare-associated infections and antimicrobial resistance (HAIAR) are serious problems, and many are preventable. The HAIAR team at DOH oversees six programs that work to prevent HAIARs in healthcare and community settings across the state. The team does this work by building partnerships across the healthcare system and providing opportunities for education, information, and connection.
Watch this video to learn more about what the HAIAR team does and how they support providers, public health professionals, and partners across the healthcare system to prevent the spread of infections.
Lisa Hannah, 2022 McKnight Prize for Healthcare Outbreak Heroes Recipient
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Lisa Hannah, RN, CIC, is the Infection Prevention Team Supervisor at the Washington State Department of Health. Read about how her infection prevention and control work during the ongoing COVID-19 pandemic and her dedication to serving rural counties across Washington state earned her the 2022 McKnight Prize for Healthcare Outbreak Heroes. |
TRAINING OPPORTUNITIES
*NEW* IP Education at your Fingertips!
Sign up to receive Washington Project Firstline text messages! Beginning June 1st, get timely infection prevention updates over your phone, wherever you are, including access to:
- Short, informative infection control training videos from the CDC.
- Tips and tools for developing staff’s foundational infection prevention knowledge.
- Infection prevention fast facts to help raise awareness and keep infection control top of mind.
- In minutes a week, this resource can help you engage your team in infection prevention!
Sign up today! Text "JoinWAIPC" to 59309 to receive text updates from the Washington Project Firstline team or hover over the QR code to sign up!
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Cause: Candida auris is an emerging, often multidrug resistant, yeast first identified in Japan in 2009. It can cause invasive healthcare-associated infections with high mortality.
Illness and treatment: Healthy people usually do not get infections due to C. auris. Common infections associated with C. auris include blood stream and wounds. Mortality associated with C. auris infections is estimated to be 30-60%. However, many of these cases had other serious illnesses which may have caused or contributed to their deaths. C. auris may also colonize on the skin and other body sites. Both infected and colonized patients can transmit the organism to others. For treatment guidance, consultation with an infectious disease specialist is highly recommended. CDC does not recommend treatment of C. auris identified from non-invasive sites (such as respiratory tract, urine, and skin) when there is no evidence of infection.
Sources: The most common sources for colonization or infection with C. auris are from health care worker's hands and other contaminated objects in the healthcare environment.
Additional Risks: In the United States, C. auris has been predominantly identified among patients with extensive exposure to ventilator units at skilled nursing facilities and long-term acute care hospitals, and those who have received healthcare in countries with extensive C. auris transmission.
Prevention: The best way to prevent colonization and infections with C. auris is through strict infection control precautions in healthcare settings including hand washing; placing patients infected with C. auris on "contact precautions" (private room, caring for patient with gloves and gown); minimizing the use of invasive devices such as central venous lines, urinary catheters, and ventilators; and using antibiotics only when necessary and for the minimum time.
Visit the DOH C. auris page for more information.
Resources for infection preventionists:
 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 difficile infection & increased odds of Methicillin-Resistant Staphylococcus Aureus (MRSA) colonization or infection.
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This fact sheet written by the Antimicrobial Stewardship Team contains additional statistics & information on this important patient safety topic, as well as links to resources to support facilities in their penicillin de-labeling journey.
Medical Providers’ Frequently Asked Questions About Urinary Tract Infections (UTI): Evidence for Safe Management of Suspected UTIs
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This FAQ document is designed to provide an evidence-based perspective on some common concerns that factor into antibiotic prescribing for asymptomatic bacteriuria.
Study: Antibiotics don't reduce risk of death from viral respiratory infections
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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.
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 incentivizes of up to $5,000 by completing specific activities.
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.
Getting Started with the NHSN AUR Module Office Hours
- You are invited to join: Getting Started with the AUR Module Office Hours. After registering, you will receive a confirmation email about joining the meeting.
- These office hours are to assist facilities who are either not yet reporting into the NHSN AUR module, or who are just getting started and would like to learn the very basics of the module. The format will be a 5–10-minute presentation on a feature of NHSN AUR, followed by time for questions.
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-AU module between August 1st, 2022, and March 1st, 2024. Learn more and apply for funding.
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 The HAI Epidemiology Team at the Washington State Department of Health investigates infections associated with health care facilities. The data is analyzed from state and national systems to understand and prevent HAIs in Washington.
Here is a summary report of response activities that were conducted by the HAI Epi Team from February 2022 through February 2023.
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The graph to the left shows the investigations conducted and separated by healthcare setting type. Most HAI Epi investigations were conducted in acute care settings, followed by nursing homes, and assisted living. No investigations were conducted in adult family homes or enhanced services facilities this cycle. Select the chart to view it in a larger format. |
This table to the right shows the primary organism identified during the investigations, separated by healthcare setting type. Streptococcus species were most commonly identified during investigations in acute care settings, while most of the norovirus was most common in assisted living. Select the table to view it in a larger format. |
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  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
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Washington Project Firstline has a series of online, interactive training modules on basic infection prevention and control practices. The educational, informative, and fun modules take approximately 20-minutes each to complete. Staff who complete all six modules will earn two contact-hours of continuing education credits through WA DSHS and Continuing Nursing Education at the University of Washington School of Nursing.
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The six-module series is based on CDC Project Firstline contend and focuses on the following:
- Infection Control
- How Germs Can Spread on Surfaces
- How Germs Can Spread via Respiratory Droplets
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- Proper Hand Hygiene
- Proper Use of Personal Protective Equipment (PPE)
- Cleaning and Disinfection
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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
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Become a Frontline Infection Prevention Champion Facility!
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.
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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* IP Education at your Fingertips!
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
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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.
NEW EPISODE
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NEW Episode:
Recent Episodes:
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 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. Read more about how viruses spread through the air are a respiratory hazard.
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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
- May 17th – Estimating what shape N95 likely to work for people’s faces
- June 21st – Tips for the Respirator Program Administrator
- July 19th – Tips for the employee respirator training
- August 16th - Tips for Employee Respirator Training
- September 20th - Tips for Doing Your Own Fit Tests
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
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 2nd Thursday of the month, 11:00 AM - 12:00 PM
Upcoming dates:
June 8, 2023
July 13, 2023
August 10, 2023
September 14, 2023
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Mycobacterium abscessus Cluster in Cardiac Surgery Patients Potentially Attributable to a Commercial Water Purification System
Nontuberculous mycobacteria are water-avid pathogens that are associated with nosocomial infections. This descriptive study aimed to analyze and mitigate a cluster of Mycobacterium abscessus infections in four cardiac surgery patients in Boston, Massachusetts. Commonalities among cases were sought, potential sources were cultured, patient and environmental specimens were sequenced, and possible sources were abated. Annals of Internal Medicine, April 19, 2023.
Outbreaks of SARS-CoV-2 Infections in Nursing Homes during Periods of Delta and Omicron Predominance, United States, July 2021–March 2022
This article from Emerging Infectious Diseases explains howSARS-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, mixed Delta/Omicron, and Omicron 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. Once infected, boosted residents were at lower risk for all-cause hospitalization and death than primary vaccine–only residents.
Impact of Patient Safety Climate on Infection Prevention Practices and Healthcare Worker and Patient Outcomes
Standard precautions may prevent patient health care associated infections and provider occupational exposures but are not often used by health care workers. A positive patient safety climate might contribute to improved adherence. The aim of this study was to determine the relationships among patient safety climate, standard precaution adherence, and health care worker exposures and HAIs.
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 Strategies for Prevention and Response to Novel & Targeted Multidrug-Resistant Organisms (MDROs)
CDC has developed two guides and FAQs for healthcare facilities, state, local, and territorial health departments to limit the spread of novel or targeted (e.g., Candida auris, carbapenemase-producing CRE) MDROs, FAQs, and a graphic showing the relationship between prevention and response activities.
New Policy Templates for Visitation and Cohorting in Long Term Care Facilities
Comagine has developed Policy Templates for Visitation and Cohorting in Long Term Care Facilities. These are most appropriate for Skilled Nursing Facilities. These policy templates do not replace local, territorial, tribal, state, or federal requirements. Facilities are responsible for updating policies to reflect the most current guidance for their setting types.
Immunize.org Updates Standing Orders Template for Administering Pneumococcal Vaccines
Many healthcare facilities simplify vaccination through the use of standing orders. Immunize.org has made important updates to its Standing Orders for Administering Pneumococcal Vaccines (PCV15, PCV20, and PPSV23) to Adults. This is based upon updated guidance published in CDC’s 2023 Recommended Immunization Schedule for Adults. This includes the option to administer PCV20 to adults age 65 and older who completed vaccination with PCV13 and PPSV23 at least 5 years earlier. Recommendations have been displayed in four tables separated by age and health status.
May 5th was World Hand Hygiene Day
The Hand Hygiene in Healthcare Settings Video Series is available for healthcare personnel to learn how to Engage, Educate, Execute and Evaluate hand hygiene programs in healthcare settings.
 The Department of Social and Health Services continues to contract with a temporary nurse staffing agency to provide Rapid Response Team short-term staffing support. Please reference the Rapid Response Team letter for details on how to request this free service.
*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 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.
Emergency Rule Making (CR-103E)
WAC 388-71-0876 When must long-term care workers who were working or hired during the COVID-19 public health emergency complete training including required specialty training? WAC 388-112A-0081 When must long-term care workers who were working or hired during COVID-19 public health emergency complete training including required specialty training? This emergency rule supersedes the emergency rule that was filed as WSR 23-04-055. This emergency rule was filed on April 17, 2023, as WSR 23-09-052 and SHS 4951.6.
A letter to AFH providers regarding the following topic is now available online:
Announcing a Training Opportunity for AFH Owners and Resident Managers
Home and Community Services (HCS) is offering a series of voluntary training courses for AFH providers who work with Medicaid-eligible clients. The training is presented by a panel of HCS subject matter experts and will offer information, resources, and support. The free courses will be available each quarter on different subjects of interest and will offer Continuing Education Units (CEUs)*.
HCS Overview for AFH Providers – Programs and Eligibility (1.5 CEUs)
- Overview of Medicaid programs and support available in an AFH.
- Overview of client functional eligibility for Medicaid services.
- How to review a CARE assessment.
- When to connect with your case manager and an overview of other resources.
- CEUs available with attendance and participation.
Registration is now open. Select the date/time that is most convenient:
May 17th, 10:00 AM-12:00 PM Ι Register
May 19th,1:00 PM-3:00 PM Ι Register
You are subscribed to Healthcare-Associated Infections and Antimicrobial Resistance (HAI&AR) Newsletter for Washington State Department of Health. This information has recently been updated, and is now available.
 If you aren't already signed up for the Healthcare Associated Infections and Antibiotic Resistance newsletter, please visit the Department of Health's email subscribers page here.
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