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COCA Call: Recommendations for Influenza, COVID-19 and RSV Vaccines for Older Adults
On September 19 at 11:00 a.m. CDC presenters will provide updates about the latest clinical considerations for administering influenza (flu), COVID-19 and respiratory syncytial virus (RSV) vaccines to adults 60 years and older and discuss resources and communication strategies that may help facilitate vaccination. Visit the webpage for more information and to access the Zoom link.
Protecting Residents from Influenza and RSV in Your Adult Family Home
Please join a panel of experts from the Department of Health (DOH), Clark County Public Health and the Department of Social and Health Services (DSHS) on October 5, from 1:30-3:00 p.m. This session will focus on crucial strategies for preventing flu and RSV outbreaks in adult family homes (AFH), along with steps to take in the event of an outbreak. Engage with our panel, ask questions, and gain valuable insights to safeguard the health of residents and staff. Adult Family Home Council members who attend the entire webinar will be eligible for 1.5 hours of continuing education (CE) credit.
Safeguarding Long-term Care Residents from COVID, Flu, and RSV
Join us October 17 at 10:00 a.m. for an informative webinar on best practices for safeguarding long-term care residents from COVID-19, influenza, and RSV. Learn crucial strategies to ensure their health and well-being in the face of respiratory illnesses.
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September is Sepsis Awareness Month, and the CDC encourages patients and healthcare professionals to get ready by sharing the Get Ahead of Sepsis resources and to learn how to protect themselves, their loved ones, and their patients from sepsis.
Download and share CDC’s FREE healthcare professional education materials with your colleagues to educate them about how to recognize signs and symptoms of worsening infection and sepsis, how to get ahead of sepsis, and what to do if they suspect sepsis.
Educate your patients and their families about:
- Preventing infections
- Keeping cuts clean and covered until healed
- Managing chronic conditions
- Recognizing early signs and symptoms of worsening infection and sepsis
- Seeking immediate care if signs and symptoms are present
CDC Hospital Sepsis Program Core Elements: On August 24, the CDC released the first-ever Hospital Sepsis Program Core Elements. This resource is intended to help U.S. hospitals improve patient outcomes from sepsis by facilitating the implementation, monitoring, and optimization of hospital sepsis programs. Hospitals implementing the Hospital Sepsis Program Core Elements can tailor their sepsis program and clinical tools to the many populations that are served by an individual hospital, which may include pediatrics, adults, maternity, and other populations.
The CDC encourages patients and healthcare professionals to share the Get Ahead of Sepsis resources and to learn how to protect themselves, their loved ones, and their patients from sepsis.
September is Dental Infection Control Awareness Month (DICAM), an annual campaign hosted by the Organization for Safety, Asepsis, and Prevention to bring awareness to infection prevention and control (IPC) in dental settings. DICAM 2023 will focus on a different topic each week and you can download OSAP’s social media toolkit for more resources.
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 Oncology Infection Control Assessment and Response
Oncology patients face heightened susceptibility to infections due to the immune-suppressing nature of cancer treatments. This vulnerability exposes them to a range of infections including respiratory, bloodstream, and urinary tract infections.
To ensure oncology settings have the appropriate infection control practices in place, the Department of Health’s Infection Prevention team has created an oncology focused workgroup comprising seasoned infection preventionists (nurses and epidemiologists) with oncology backgrounds, occupational health nurses, and an industrial hygienist.
This oncology workgroup partnered with a frontline infection preventionist from a major comprehensive cancer center in Seattle to develop an oncology focused Infection Control Assessment and Response (ICAR) tool.
Our goal is to provide additional infection control support to oncology facilities in Washington state to help reduce the risk of infections to this vulnerable patient population. We are currently reaching out to facilities and various communities to spread the word about our non-regulatory, free ICAR consultations which will be available on-site as well as via televisit.
The CDC has released new resources to assist nursing home staff with understanding the benefits of and implementing Enhanced Barrier Precautions (EBP). This new suite of resources will help staff, residents, and loved ones learn more about why EBP are important and when these practices should be used. We encourage you to share these resources widely.
Videos
Print Resources
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 General Updates:
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New WA DOH Resources:
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CDC’s Antibiotic Resistance and Patient Safety Portal Updates:
Educational Opportunities:
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Antimicrobial Stewardship of Urinary Tract Infections in the Long-Term Care Setting Educational Series
- The Washington Department of Health, in collaboration with the Washington State Society for Post-Acute and Long-Term Care Medicine (WA-PALTC), is hosting a webinar series with FREE continuing education credits for Physicians and Pharmacists.
- Save the Date! NHSN AU Option: Using Data for Action in Critical Access Hospitals
- The CDC and the Health Resources and Services Administration’s Federal Office of Rural Health Policy are co-hosting a webinar on November 14th. Speakers will describe requirements for meeting the Antimicrobial Use and Resistance (AUR) Measure within the Centers for Medicare and Medicaid Services (CMS) Promoting Interoperability Program and using the National Healthcare Safety Network (NHSN) Antimicrobial Use (AU) data for action in critical access hospitals.
Clinical Pearls:
- New Consensus Statement for the Use of Prolonged-Infusion Beta-Lactam Antibiotics
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These recommendations provide the first consensus guidance for the use of β-lactam therapy administered as prolonged infusions.
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OFID Article: Two Times Versus Four Times Daily Cephalexin Dosing for the Treatment of Uncomplicated UTIs in Females
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This study concludes that twice daily cephalexin is as effective as four times daily doing for uncomplicated UTI.
Reminders:
- WA DOH’s NHSN AUR Implementation FAQ
- The Centers for Medicare and Medicaid Services (CMS) will be requiring all hospitals 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. Additionally, a new page has been added to page 2 describing the specific updates.
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WA DOH’s 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 will now be hosted quarterly.
- 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 five-to-ten-minute presentation on a feature of NHSN AUR, followed by time for questions.
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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 a $5,000 financial reimbursement to hospitals that start reporting to the NHSN-AU module between August 1, 2022, and March 1, 2024.
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 The National Healthcare Safety Network (NHSN) Patient Safety Component Annual Facility Survey collects facility-level HAI reporting practices during the prior calendar year. Each year, all facilities enrolled in the NHSN Patient Safety Component must complete a survey that includes questions about facility characteristics, laboratory, infection control, newborn care, antibiotic stewardship, sepsis practices, and water management. This survey helps understand current practices in healthcare settings and tailor outreach.
The figures below show facility characteristics data from the 2022 Annual Survey for 89 acute care hospitals (ACHs, represented in red and orange) and critical access hospitals (CAHs, represented in blues) in Washington. These data help understand the landscape of healthcare facilities in Washington.
Figure 1 breaks down the proportion of facilities that are a part of a larger corporation and those that are independently operated. Most facilities in Washington are a part of a larger corporation.
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Figure 2 shows the number of facilities in different bed size categories. CAHs are smaller, and, thus, all CAHs fall into the smallest two categories with fewer than 50 beds. Larger hospitals with more beds are more likely to be a part of a corporation.
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  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
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.
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 nwcphp.org and are offered in English and Spanish.
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 two (free) contact hours of CEs/CNEs.
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Once 90% of your staff complete all six 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!
Infection Prevention Education at your Fingertips!
This new resource can help better engage your team in infection prevention! Sign up to receive free Washington Project Firstline text messages! Receive timely infection prevention updates over your phone, wherever you are, including access to:
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• Infection prevention fast facts to help raise awareness and keep engaged with infection control topics.
• Short, informative infection control training videos from the CDC.
• Tips and tools for developing staff’s foundational infection prevention knowledge.
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Sign up today! Text "JoinWAIPC" to 59309 or hover over the QR code to receive free text updates from the Washington Project Firstline. Don't forget to remind your healthcare friends, family, and coworkers/staff to sign up!
 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.
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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.
The WA DOH support for respirator (N95) use will be changing starting on November 30. There are three types of support currently provided by the WA DOH HAI/AR Occupational Health team:
- 3M online medical evaluation,
- Fit testing and fit tester training, and
- Consultation support for the rules and regulations of respiratory protection.
3M Online Medical Evaluation changes:
After December 29, 2023, DOH will no longer cover the cost of 3M medical evaluations. The 3M system will be unavailable from December 30th through January 2, 2024, when facility accounts will be removed from DOH’s account. Facilities will be able to access their account on January 2, 2024. Starting January 2, 2024, facilities wanting to stay with 3M, will need to prepay for their medical evaluations. You will continue to use the same login to access your account. Each medical evaluation will cost $29 and there is no expiration date for unused medical evaluations.
To prepare for this change, DOH will stop accepting requests to set up new accounts for facilities in 3M after November 30, 2023. Facilities that have a 3M account as of December 1, 2023, will have until December 29, 2023, to get their accounts up to date and have their staff complete their medical evaluation.
Fit Testing and Fit Tester Training:
We are no longer providing services for facilities requesting annual fit testing. Our recommendation is for facilities to learn how to conduct their own fit testing. If you feel you will need in person support after attending our Fit Tester Training webinar, please complete this form. We are not accepting requests from facilities to provide fit testing during outbreaks. We anticipate that fit tester training services will end June 30, 2024. We encourage you to engage with our training opportunities now, so your facility is prepared to provide your own fit testing in the future.
Consultation support from the DOH HAI/AR Occupational Health Team:
To assist facilities with the requirements for their respiratory protection program we have the following webinars:
We anticipate that most RPP consultation services will end June 30, 2024. We encourage you to engage with our training opportunities now, so that your facility is prepared to manage your own RPP in the future.
If you have additional questions, please feel free to email us at
HAI-fitTest@doh.wa.gov.
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Quarterly NHSN User Group for Hospitals
*Calls are facilitated through TEAMS*
Please contact Sandy Ng for a TEAMS invitation
Next session is October 10, 10:30 – 11:30 a.m.
This is a 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 for the second Thursday of the month, 11:00 a.m. – noon.
Upcoming dates:
October 12, 2023
November 9, 2023
December 14, 2023
NHSN Reporting Updates and Trainings
The NHSN Vaccination Team will be hosting multiple webinars for facilities reporting COVID-19 vaccination data in the NHSN LTCF and HPS Components.
Key Points:
- The FDA approved updated 2023-2024 COVID-19 vaccines for this fall/winter season. The bivalent vaccines are no longer authorized as of 9/12/2023.
- The CDC recommends everyone 6 months and older should receive the 2023-2024 updated COVID-19 vaccine to protect against serious illness from COVID-19 and to remain up to date.
- Under the new recommendations, most individuals will not be up to date with COVID-19 vaccines until they receive the 2023-2024 updated COVID-19 vaccine.
- The new definition of up to date with COVID-19 vaccines will apply for NHSN surveillance beginning the week of September 25, 2023 – October 1, 2023 (the first week of reporting Quarter four of 2023).
NHSN Surveillance Trainings for the Healthcare Personnel Safety Component: Up to Date Vaccination Status: Surveillance Definition Change
September 19, 2:00 p.m. ET
September 26, 2:00 p.m. ET
NHSN Surveillance Trainings for Long-term Care Facilities: Up-to-Date Vaccination Status: Surveillance Definition Change for Long-term Care Facilities
Replay training sessions are now available for the following dates. Visit the webpage for more information and registration.
Replay Sessions:
September 22: Up to Date Vaccination Status: Surveillance Definition Change for Long Term Care Facilities (Replay)
September 25: Up to Date Vaccination Status: Surveillance Definition Change for Long Term Care Facilities (Replay)
October 2: Up to Date Vaccination Status: Surveillance Definition Change for Long Term Care Facilities (Replay)
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 An Overview on Candida auris in Healthcare Settings.
This article provides an overview on C. auris in healthcare settings. Candida auris has become a major concern in critical care medicine due to the increasing number of immunocompromised patients and candidiasis is the most frequent cause of fungal infections. C. auris and other fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year. Screening patients for C. auris colonization enables facilities to identify individuals with C. auris colonization and to implement infection prevention and control measures. This pathogenic fungus shows an innate resilience, enabling survival and persistence in healthcare environment and the ability to rapidly colonize the patient’s skin and be easily transmitted within the healthcare setting, thus leading to a serious and prolonged outbreak.
The Father of Infection Control
Known as the “father of infection control”, Dr Ignaz Semmelweiswas, was a Hungarian born physician who received his MD degree in Vienna in 1844. In 1847 he was given a two-year appointment as an assistant in obstetrics with responsibility for the First Division of the maternity service of the vast Allgemeine Krankenhaus teaching hospital in Vienna. There he observed that women delivered by physicians and medical students had a much higher rate (13–18%) of post-delivery mortality (called puerperal fever or childbed fever) than women delivered by midwife trainees or midwives (2%).
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A 7-year analysis of attributable costs of healthcare-associated infections in a network of community hospitals in the southeastern United States
In this article, Researchers calculated the attributable cost of several healthcare-associated infections in a community hospital network: central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), hospital-onset Clostridioides difficile infections (CDI-HOs) (43 hospitals); surgical site infections (SSIs) (40 hospitals). From 2016 to 2022, the total cost of CLABSIs, CAUTIs, CDI-HOs, and SSIs was $420,012,025.
An Overview on Candida auris in Healthcare Settings
This article provides an overview on C. auris in healthcare settings. Candida auris has become a major concern in critical care medicine due to the increasing number of immunocompromised patients and candidiasis is the most frequent cause of fungal infections. C. auris and other fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year. Screening patients for C. auris colonization enables facilities to identify individuals with C. auris colonization and to implement infection prevention and control measures. This pathogenic fungus shows an innate resilience, enabling survival and persistence in healthcare environment and the ability to rapidly colonize the patient’s skin and be easily transmitted within the healthcare setting, thus leading to a serious and prolonged outbreak.
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 Puget Sound Chapter
The Puget Sound Region APIC chapter meets on the fourth Thursday of every month from noon to 2:00 p.m.
- We review important legislative updates, IPC news, and educational opportunities.
- Journal club and round table discussions keep IPs up-to-date on recent activity in the IPC field, as well as connect with local IPs.
Register in advance for meetings. Links to registration sites can be found on our social media and website a few weeks prior.
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 This updated Viral Hepatitis resource, from the Council for Outbreak Response, outlines recommended practices for healthcare outbreak response for viral hepatitis. Topics include an overview of viral hepatitis, a toolkit to investigate possible transmission, and other key resources to aid infection prevention and control efforts in healthcare settings.
This new Group A Streptococcus (GAS) resource, from the Council for Outbreak Response, provides an overview of GAS and features other resources for identifying and managing outbreaks, recommendations for the control of invasive GAS among exposed household contacts, and other resources to guide healthcare outbreak response.
CDC’s Latest Safe Healthcare Blog | HICPAC Updates: CDC’s evidence-based guidelines for health care are designed to protect healthcare workers and patients, encourage safe practices, improve health outcomes, and save lives. Read a recent Safe Healthcare Blog to learn about the Healthcare Infection Control Advisory Committee (HICPAC), a federal advisory committee, and their latest progress reviewing the 2007 Isolation Precautions guideline.
SHEA/IDSA/APIC Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: The next section of the 2022 update to the Compendium of Strategies to Prevent HAIs has been published in Infection Control & Hospital Epidemiology (ICHE) and is available here. As noted in the update, “The intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts.”
During a pandemic or other emergency, health care facilities face significant challenges to quickly onboard additional health care providers when hospital admissions and intensive care units’ occupancy rapidly increase. The recently updated Health Care Facility Onboarding Checklist can help facilities ensure new employees are compliant with administrative requirements, familiar with the mission and culture of the hospital, and understand expectations.
 A letter to AFH providers and stakeholders regarding the following topic is now posted online:
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You are subscribed to Healthcare-Associated Infections and Antimicrobial Resistance (HAI&AR) Newsletter for Washington State Department of Health.
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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