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View the Updated Visitation Videos for Long-Term Care Settings
 The Strategic Partners Program in the Healthcare-Associated Infections and Antimicrobial Resistance (HAIAR) section of the Washington State Department of Health (DOH) is pleased to announce the release of three updated educational videos to help visitors to long-term care (LTC) settings learn about basic infection control measures for preventing COVID-19, flu, and other infectious diseases.
The LTC Visitation Guidance video describes basic infection prevention practices, while the LTC Isolation Precautions Guidance video covers the proper use of personal protective equipment when visiting someone who is in quarantine. The Adult Family Home Visitation video provides basic visitation guidance specific to adult family home settings.
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Join CDC in November for C. diff Awareness Month to raise awareness about this deadly threat and save lives.
Infection control plays a critical role in stopping the spread of C. diff in healthcare settings. It’s important that all healthcare personnel understand the infection control actions they should take to stop the spread of germs. CDC’s Project Firstline provides innovative and accessible infection control resources so you can help keep your patients safe.
Healthcare professionals—download, share, and order:
Visit CDC’s C. diff website to learn more.
Improve Antibiotic Use, Improve Health Equity
The U.S. Antibiotic Awareness Week (USAAW) with CDC Kick off Began Saturday, November 18!
Every year, CDC recognizes USAAW to raise awareness and share information on the importance of improving antibiotic and antifungal use. Any time antibiotics or antifungals are used they can cause side effects and contribute to antimicrobial resistance (AR). The USAAW observance is aligned with World Antimicrobial Resistance Awareness Week (WAAW) during the same week.
This year, CDC is focusing on the connection between appropriate antibiotic and antifungal prescribing and use and health equity. Health equity means everyone has a fair and just opportunity to attain their highest level of health. Health inequities resulting from less-than-optimal antibiotic or antifungal prescribing practices may impact health outcomes, and result in an increase in antimicrobial resistance or adverse events in some populations. Join CDC November 18-24 as we recognize the importance of improving antibiotic and antifungal prescribing and use, improving health equity, and slowing the spread of antimicrobial resistance. Learn how you can take action this week and the rest of the year.
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 Get to know the Infection Prevention and Control Program Team
 We are excited to present this new video spotlighting the Infection Prevention and Control Program (IPCP) team within the Disease Control and Health Statistics division's Office of Communicable Disease Epidemiology.
Take a deep dive into the essential services we provide, gaining valuable insight into our pivotal role in protecting public health through effective prevention and control measures. We invite you to watch this video to learn more about the dedicated efforts and expertise our team brings to the forefront of health care infection prevention and control.
Please visit the IPCP web page for additional information.
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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Antibiotic Awareness Week 2023:
- WA DOH’S AMS team would like to wish all our stewards a Happy Antibiotic Awareness Week! This event takes place from November 18 through 24. WA’s theme is penicillin allergy delabeling and our celebration will include the following:
- A brand-new subpage with links to penicillin allergy delabeling resources, including implementation guidance and a clinical decision support tool.
- Daily patient-focused social media posts.
- A pre-recorded webinar series consisting of four short webinars.
- Three brand-new patient educations.
- An eight-minute podcast for patient and clinician education.
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New For Antibiotic Awareness Week:
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Antimicrobial Stewardship Toolkit for Nursing Homes
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This toolkit contains resources that can assist facilities with practical implementation and maintenance of an antimicrobial stewardship program.
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Urine PCR Guidance Document for Long-Term Care Facilities
- Urine polymerase chain reaction-based (PCR) laboratory testing has been promoted to clinicians as an alternative method of obtaining urine cultures. Due to the high prevalence and overuse of antibiotics for asymptomatic bacteriuria (ASB) in the post-acute and long-term care population, guidance on the topic of PCR urine testing is provided to ensure safety. This document is listed under the “Education” header here.
Clinical Pearls:
- Antibiotic Stewardship in Outpatient Telemedicine: Adapting Centers for Disease Control and Prevention Core Elements to Optimize Antibiotic Use
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Utility of triazole antifungal therapeutic drug monitoring: Insights from the Society of Infectious Diseases Pharmacists
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This insight describes the pharmacokinetic principles and pharmacodynamic targets of commonly used triazole antifungals and provides the rationale for utility of therapeutic drug monitoring within each agent.
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ASHP/SIDP Joint Statement on the Pharmacist’s Role in Antimicrobial Stewardship
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Inappropriate Antibiotic Prescribing Leads to Increased Costs Complications
- The Pew Charitable Trusts has developed a fact sheet detailing the economic and clinical consequences associated with inappropriate antibiotic prescribing. The fact sheet combines the safety and cost studies associated with inappropriate antibiotic use done in adults and pediatric populations. These data provide additional evidence on the importance of outpatient antibiotic stewardship and can serve as a resource for health department staff trying to strengthen their outpatient stewardship programs.
Support for the Reporting to the NHSN Antimicrobial Use and Resistance (AUR) Module:
- WA DOH’s NHSN AUR Implementation FAQ
- 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. 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
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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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 Race and Ethnicity Data Reported to NHSN
When completing mandated reporting of healthcare-associated infections (HAIs) to the National Healthcare Safety Network (NHSN), hospitals enter data on the HAI event and the patient. While some patient information is required for reporting, the race and ethnicity fields are optional. These data are frequently left blank, impacting the understanding of race and ethnicity inequities in HAIs.
The graphs below show the little data we have on race and ethnicity for all HAIs reported from January to December 2022. We encourage facilities to report race and ethnicity data into NHSN when submitting HAI events. Without hospitals completing this optional reporting, the Washington State Department of Health (WA DOH) NHSN Epidemiology team is left unable to identify the impact that race and ethnicity inequities has on HAIs in Washington State.
Percentage of Any Race or Ethnicity Data for all HAIs, 2022
In 2022, 4015 HAIs were reported to NHSN, marked by the blue bar. Less than 10% of those cases included any race or ethnicity data, with 8.9% of events containing race data and 6.9% of events containing ethnicity data.
Race and Ethnicity for all HAIs, 2022
The pie charts below show the race and ethnicity data that was reported in 2022. The vast majority of HAIs in Washington occurred in patients who identified as White (89%) and Non-Hispanic (94%). More reporting is needed for more robust analyses.
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  Washington State Department of Health to provide frontline healthcare workers with infection prevention and control education and training.
Want to Become an Infection Control Superhero? We have the Perfect Start!
Start your journey to becoming an infection control superhero by taking the Washington State Project Firstline Leaning 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.
The six-module series is based on CDC Project Firstline content 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.
All corresponding job aids are now also offered in Russian, Tagalog, and Vietnamese. Check it out on our website under Education and Training!
Washington Project Firstline Promotional Flyer
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Continue your superhero journey by checking out how your facility can become a Frontline Infection Prevention Champion!
Details can be found on our website and via this informational flyer.
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Infection Prevention Education at your Fingertips!
Enhance your team's engagement in infection prevention! Text "JoinWAIPC" to 59309 (or scan the QR code) to receive free Washington Project Firstline text messages on 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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Don't forget to remind your healthcare friends, family, and coworkers/staff to sign up!
Text Campaign Flyer
CDC Project Firstline Micro-Learns!
Micro-learns are short, adaptable training resources to educate your team on a variety of topics through guided discussions. These discussions aim to assist in connecting infection control concepts to practice, helping healthcare workers recognize infection risks and to take action to stop the spread of germs. These micro-learns can be incorporated into your next team meeting or huddle.
Current topics include: (What to do when you see…)
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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. |
Recent Episodes:
• Antimicrobial Stewardship Mini-Series: Penicillin Allergies
• Antimicrobial Stewardship Mini-Series: Introduction
• Standard and Transmission-Based Precautions
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There are three types of support currently provided by the WA DOH HAI/AR Occupational Health team:
- 3M online medical evaluation (new account additions ending on November 30, 2023)
- Fit tester training
- Consultation support for the rules and regulations of respiratory protection
The DOH HAI/AR Occupational Health team will continue to provide consultation support for your respiratory protection needs through June 30, 2024.
Reminder of the upcoming changes:
- November is the last month DOH will be adding new facilities to the DOH sponsored 3M account for medical evaluations. DOH will not add new facilities after November 30th. Contact the Occupational Health team now to get your facility added. Email HAI-FitTest@doh.wa.gov today.
- Initial or annual fit testing for non-skilled nursing facilities is no longer being supported by the DOH Occupational Health team. Visit our website to learn more about how to do your own fit testing.
Consultation support:
To assist facilities with the requirements for their respiratory protection program we have the following webinars:
If you have additional questions, please feel free to email us at
HAI-fitTest@doh.wa.gov.
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Now Available: WA DOH NHSN Device-Associated HAI Dashboard
The Washington State Department of Health (WA DOH) released a Device-Associated HAI Dashboard, containing NHSN data for catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs). The dashboards let you see the progress Washington State hospitals have made in reducing HAIs, and how our hospitals are currently performing. Data will be updated annually.
The dashboard is available through the HAI Epidemiology and Reporting webpage or through the WTN HAI landing page, where more information can be found on the data included in the dashboard.
Quarterly NHSN User Group for Hospitals
NEW FOR 2024: NHSN User Group Calls for Hospitals will occur every other month on the second Tuesday from 10:30 a.m. to 11:30 a.m.
January 9, 2024
March 12, 2024
May 14, 2024
July 9, 2024
September 10, 2024
November 12, 2024
Please contact Sandy Ng or Meghan Linder for an invitation.
Monthly Long-Term Care NHSN User Group
You are invited to register for the monthly NHSN skilled nursing facilities (SNFs) forum to share and, collaborate, improve reporting accuracy, and increase user knowledge. Calls are scheduled for the second Thursday of the month, 11:00 a.m. – noon. With the next meeting scheduled for December 14, 2023.
Please contact Paula Parsons for more information
NHSN Reporting Updates and Trainings
The NHSN Long Term Care and Vaccination Teams will be hosting webinars that focus on Reporting Influenza and RSV Cases and Vaccination for Long-term Care Facility Residents. Long-term care facilities (LTCF) will now be able to report influenza and RSV vaccine and case information in addition to reporting COVID-19 vaccine and case information for LTCF residents. Reporting influenza and RSV data for LTCF Residents is optional and will be completed through the Long-term Care (LTC) Component. LTCFs should continue to follow reporting requirements for submitting COVID-19 data information for residents and staff.
Long-term Care Facilities (LTCFs) can now prepare for collecting annual healthcare personnel (HCP) influenza vaccination summary data for the 2023-2024 influenza season. The reporting period for the 2023-2024 influenza season for Annual Healthcare Personnel (HCP) summary data is from October 1, 2023, through March 31, 2024. Facilities are only required to submit one report that covers the entire reporting period through the NHSN Healthcare Personnel Safety (HPS) Component, which is due in May 2024.
Plan to attend refresher training in November:
- Tuesday, November 21, 2023, at 1:00 p.m. EST
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Register in advance for this webinar.
- Tuesday, November 28, 2023, at 1:00 p.m. EST
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Register in advance for this webinar.
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 Guidelines for the management of norovirus outbreaks in acute and community health and social care settings
Previous UK guidelines were published over a decade ago, and new knowledge and technologies have since emerged. These updated guidelines focus on infection prevention and control (IPC) principles which aim to reduce the norovirus burden in healthcare and social settings, while maintaining essential services and minimizing disruptions during the outbreaks.
Norovirus is the most common cause of acute gastroenteritis in the U.S. Each year, norovirus causes 19 to 21 million cases of acute gastroenteritis in the U.S. There are many types of norovirus and you can get it more than once.
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Long-term care certification in infection prevention: The time is…now!
In 2018, with collaboration from the APIC Board of Directors, the Certification Board of Infection Control and Epidemiology, Inc (CBIC) began the process of developing a distinct certification pathway for LTC IPs using the same rigorous process as the Certification in Infection Control (CIC) credential. The purpose of this paper is to describe the LTC certification examination developments.
Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. Researchers therefore performed a systematic literature review to examine the effect of IPC measures in the long-term care setting.
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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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New Studies about Pathogen Reduction Strategies
CDC has been involved in two recent studies about strategies that decrease the number of bacterial pathogens that may lead to infection (pathogen reduction strategies). The first is an AHRQ-funded study in nursing homes, and the second is a CDC-funded study in intensive care units. Use the links below to read the publications.
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Adult Family Homes Standard Precautions Resource
The Healthcare-Associated Infections and Antimicrobial Resistance Section is proud to announce our new Adult Family Home (AFH) Standard Precautions Document. This document was created by DOH in partnership with DSHS. Our goal is to provide easy to read, best practices for infection prevention in AFHs.
There are 11 areas of infection prevention listed with links to resources. To accommodate varying preferences, we are offering two versions of this document. One is available as a user-friendly PDF, while the other is designed for print, featuring convenient QR codes for seamless access to resources.
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 Sunsetting the U.S. Government (USG) COVID-19 Therapeutics Distribution Program — This guide is intended to provide direction as the USG prepares to wind down the current distribution of USG-procured COVID-19 therapeutics and transition of the COVID-19 Oral Antiviral (OAV) treatments (nirmatrelvir packaged with ritonavir, Paxlovid, and molnupiravir, Lagevrio) to the commercial market. This guide aims to help jurisdictions and providers (1) plan for the transition away from USG ordering; (2) understand the impact of this transition on ordering mechanism; (3) understand how to manage inventory of USG distributed OAV products, including continued reporting requirements for remaining USG inventory; and (4) provide summary information about programs to provide access for uninsured and under-insured individuals once COVID-19 OAVs become commercially available. This guide is for planning purposes only. Details may change.
To learn more, please visit: COVID-19 Therapeutics Commercialization Transition Guide
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NHSN Nursing Home Reporting Changes for New “Up to Date” COVID-19 Vaccination Definition
As part of the new ACIP and CDC recommendations for COVID-19 vaccines, CDC has changed the definition of “up to date”. Data collected in the National Healthcare Safety Network (NHSN) Weekly Long-term Care COVID-19 Vaccination Modules and Long-term Care COVID-19 Module will be revised for reporting weeks beginning on September 25, 2023, to align with this definition. CDC will host training webinars for long-term care facilities, including nursing homes, about how to accurately report the number of individuals who are up to date under the new guidance. Updates and information about upcoming training can be found on the CDC webpage.
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A letter to all care settings regarding the following topic is now available online:
Letter to Nursing Home Administrators regarding the following topics are now available online:
Letters to Adult Family Home providers and stakeholders regarding the following topics are now posted online:
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.
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