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Interim COVID-19 Outbreak Definition for
Healthcare Settings
The Department of Health has adopted the updated COHRA/CSTE outbreak definition for healthcare on January 1st. The major changes are detailed here, and the full definition can be found at the link below.
- Changes the threshold for a long-term care outbreak from only 1 resident case to 2 resident cases within 7 days.
- Changes healthcare personnel only outbreaks from 3 healthcare personnel to 2 healthcare personnel and 1 resident case. (there are no more healthcare personnel only outbreaks).
- Removes outpatient care.
Note:
- Facilities with a CLIA waiver still have an obligation to report all lab confirmed cases of COVID-19 to public health.
- This guidance does not change any reporting requirements to regulatory bodies such as DSHS or HSQA.
For questions about this change, please reach out to haiepioutbreakteam@doh.wa.gov; read the full definition.
Read the DOH specific guidance!
Health Alert Network Health Advisory:
CDC issued this Health Alert Network (HAN) Health Advisory on December 14, 2023 to alert healthcare providers to low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus). Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes COVID-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks.
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CDC: 2024 Immunization Schedules are now available and effective immediately.
Reminder: the schedules summarize final recommendations that were previously adopted and made official by the CDC director.
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Infection Prevention and Control |
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IPChat 2024!
The Healthcare Associated Infections and Antimicrobial Stewardship section is proud to announce Year 3 of the Infection Prevention and Control Health Assistance Team for Skilled Nursing Homes. IPChat, as it is commonly referred to, is a series of calls that brings together both experienced and novice Infection Preventionists (IPs) that work in skill nursing homes (SNF) to learn and discuss Infection Prevention and Control topics. This is a safe space for sharing challenges, offering solutions and networking. This twice-month call starts with a micro-learning followed up with either an open forum or Q&A of the topic covered. We bring in guest speakers from across our agency, DSHS, professional associations and individual facilities to lead the topic discussions. Our topics range from the basic to the complex, included but not limited to:
- Antimicrobial stewardship
- Outbreak notification and surveillance
- IP roles in construction, the kitchen, and laundry
- Candida auris
- Enhanced barrier precautions
- Foley catheter review and maintenance
- Safe injections
- Quality improvement processes
- Preparing for a DSHS survey
- Respirator fit testing and so much more
Participating SNF IPs can receive contact hours on federal regulatory standards for Infection Prevention and Antibiotic Stewardship. We are excited for this year’s cohort and helping them become the best Infection Preventionists they can be. Everyone has something to learn! Everyone has something to teach! We welcome your questions about this great program.
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Antimicrobial Stewardship |
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New WA DOH Resources for Long-Term Care Facilities
Antimicrobial Stewardship Toolkit for Nursing Homes
This toolkit contains resources that can assist facilities with practical implementation and maintenance of an antimicrobial stewardship program.
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.
New Resources for Penicillin Allergy Delabeling
Is It Really a Penicillin Allergy Patient Education Handout
This is a brand-new handout designed to educate patients on the importance of clarifying penicillin allergies. A Spanish translation will be posted within the next month.
Penicillin Allergy Testing Patient Education Handout
This is a brand-new handout designed to educate eligible patients on what to expect. A Spanish translation will be posted within the next month.
Penicillin Allergy Delabeling Webinars
This is a series of short, pre-recorded webinars focused on the concept and the practical applications of this topic.
Training Opportunities
Recruitment for Agency for Healthcare Research and Quality (AHRQ) Safety Program for Telemedicine: Improving Antibiotic Use Now Open
This program, beginning in June 2024, consists of brief educational presentations about best practices to optimize antibiotic prescribing in the telemedicine environment. Participants will have access to technical assistance, coaching, webinars, and practical tools to implement improvements in their practice. Continuing education units, continuing medical education credits, and ABIM MOC points will be offered at no charge for participants. Learn more and apply!
Clinical Pearls
New ISDA guidance for Community Acquired Pneumonia (CAP)
This new resource, the CAP Clinical Pathway, provides stewardship teams and other medical practitioners the guidance needed in the diagnosis and treatment of patients with suspected CAP.
New OFID Commentary Regarding the ACORN Trial
Does the ACORN trial end the debate surrounding vancomycin and piperacillin-tazobactam combination therapy and increased risk for acute kidney injury? Read the OFID commentary to learn more.
New Guidance from CDC: Be Antibiotics Aware at Hospital Discharge
This document contains recommendations for hospitals regarding antibiotic durations and discharge summaries.
New in OFID: A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2022
This paper provides an overview of the top 13 publications in antimicrobial stewardship literature in 2022.
New in OFID: An Update from the National Healthcare Safety Network on Hospital Antibiotic Stewardship Programs in the United States, 2014-2021
Authored by CDC experts, this paper provides an update on progress in hospital stewardship. This paper contains select results from the 2021 NHSN Patient Safety Component Annual Hospital Survey Antibiotic Stewardship Practices
Support for the reporting to the NHSN Antimicrobial Use and Resistance (AUR) Module
CDC’s NHSN AUR Implementation Resources
NHSN AUR Office hours
The NHSN team is hosting two upcoming office hour sessions. These sessions will start with a brief presentation and the remainder of the hour will be used for Q&A with attendees.
Wednesday, February 7: 11:00 am-12:00 pm PST. Register!
Thursday, March 7: 12:00-1:00pm PST. Register!
FAQs: AUR Reporting for the CMS Promoting Interoperability Program
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. More information available.
WA DOH’s Getting Started with the NHSN AUR Module Office Hours
Learn more & register here: Getting Started with the AUR Module Office Hours.
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. Learn more and apply for funding.
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Surgical Site Infection Rates Since 2021
Acute care hospitals (ACHs) in Washington report surgical site infections (SSIs) to the National Healthcare Safety Network (NHSN). The Center for Medicare and Medicaid Services (CMS) requires quarterly reporting of SSIs following colon surgeries (COLO) and abdominal hysterectomies (HYST). This CMS data excludes superficial SSIs and those in patients under 18. Reporting is generally delayed by six months, as the CMS deadlines provide ample time for hospital reporting. The most recent data finalized is from Quarter 2 of 2023, which contains data through June 2023.
Reported Procedures and Infection Counts and SIR, Biannually for 2021-2023
SSI rates are heavily affected by the number of procedures performed, which has been variable since the beginning of the COVID-19 pandemic.
The graphs below show the number of procedures performed, number of SSIs, and SSI SIRs for each half year starting in 2021.
Figure 1: Standardized Infection Ratio for COLO and HYST, Biannually Since 2021
 COLO
For COLO, there was an increase in the SIR during the first half of 2023. The number of procedures has been relatively stable each half year since the beginning of 2023. There were 20 more infections that occurred in the first half of 2023 (95) than the same time period in 2021 (75), with nearly the same number of procedures (3348 and 3346, respectively), explaining the increase in the SIR. It will be interesting to see if the number of infections and SIR decrease in the second half of 2023, as they have historically been lower for the second half of the year.
Figure 2: Procedure and Infection Counts for COLO, Biannually Since 2021
HYST
For HYST, the reported number of infections for the first half of 2023 (19) is comparable from the same time period in 2021 (20) and 2022 (21). Figure 1 above and Figure 3 below show the SIR increases and decreases with the number of infections, as the two lines mimic the same shape. The current SIR for Quarters 1 and 2 of 2023 is in line with the SIRs for the previous two half years.
Figure 3: Procedure and Infection Counts for HYST, Biannually Since 2017
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Quick Infection Prevention Education and Training
Need help with infection prevention training at your healthcare workplace? How about continuing education credits? Check out the education and training opportunities below to ensure you, your staff, and fellow frontline healthcare workers stay on top of infection prevention and control (IPC) practices.
Weekly Text Messages
Wondering how you can provide (and receive) IPC education in a quick and accessible manner? We have your answer: free weekly text messages. Text "JoinWAIPC" to 59309 (or scan the QR code) for timely infection prevention updates and resources. Make sure to have all your healthcare worker friends and colleagues sign-up to join in on the important resources! |
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Washington Project Firstline Online Modules
Infection prevention training on your schedule, at your own pace! This six module training series on basic IPC practices takes about 20-minutes per module. Complete all six to receive two contact hours of continuing education credits for free! Start today!
Frontline Infection Prevention Champion facility
Demonstrate your facility is actively working on educating staff in infection prevention by participating in our Frontline Infection Prevention Champion program. Find out more!
Washington Project Firstline Podcast
Listen as the Washington State Department of Health hosts a podcast series for frontline healthcare workers to increase awareness of infection prevention practices and its impact on our lives and the lives of our community.
Check out our latest episode: Antimicrobial Stewardship Mini-Series: Your Role
CDC Project Firstline Micro-Learns
Micro-Learns are guided discussions to help connect infection control concepts to practice so your staff can recognize infection risks and take action to stop the spread of germs. Incorporate these short, adaptable training resources into your next team meeting or huddle.
Current topics include: (What to do when you see…)
Use the above opportunities to show visitors, regulatory personnel, and others how you are continuing to educate, train, and learn about infection prevention practices!
NEW! Frontline Infection Prevention Champion for Training Programs
A Frontline IP Champion training program has implemented the Project Firstline online Washington Infection Prevention Training Modules and other Washington Project Firstline education and training materials into their training program curriculum. Involve your training program today!
Go to our website for more WA Project Firstline information and resources!
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Consultation support:
The DOH HAI/AR Occupational Health team will continue to provide consultation support for your respiratory protection needs by providing fit tester training and guidance through June 30, 2024.
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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National Healthcare and Safety Network (NHSN) |
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New NHSN Epidemiology Email
The NHSN Epidemiology Team has a new inbox. Please email NHSNepi@doh.wa.gov for any NHSN related questions, issues, or concerns. This will allow our team to respond to your message in a timely manner.
Now Available: Two New WA DOH NHSN Dashboards
The Washington State Department of Health (WA DOH) released two new dashboards using NHSN data: the Laboratory-Identified (LabID) HAI dashboard containing data for hospital-onset Clostridiodes difficile infection (CDI) and Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and the Surgical Site Infection dashboard containing data for SSIs following colon surgeries or abdominal hysterectomies. The LabID dashboard replaced the pre-existing CDI dashboard. The dashboards show annual data for the last five years of reportable HAI data. It also shows the progress hospitals in our state have made in reducing HAIs, and how our hospitals are currently performing. Data will be updated annually.
The dashboards, and the pre-existing device-associated HAI dashboard, are 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 dashboards.
Quarterly NHSN User Group for Hospitals
New invitation for the NHSN Hospital User Group calls in 2024. We will host these calls every other month. Please register in advance for this call series at this link. Upcoming meetings are as follows.
- Mar 12, 2024 10:30 AM
- May 14, 2024 10:30 AM
- Jul 9, 2024 10:30 AM
- Sep 10, 2024 10:30 AM
- Nov 12, 2024 10:30 AM
Please reach out to Sandy Ng if you have any questions or have topic ideas for any of the calls.
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. Upcoming meetings are as follows:
- Feb 8, 2024
- Mar 14, 2024
- Apr 11, 2024
Please contact Paula Parsons for more information.
NHSN Support Services
For a more comprehensive list of NHSN support options the HAI Epi Team can provide, see the NHSN Support and Technical Assistance for Skilled Nursing Facilities flyer.
NHSN Reporting Updates and Trainings
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.
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Association for Professionals in Infection Control and Epidemiology (APIC) |
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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.
APIC Podcasts:
AJIC Monthly Podcast
New Episode:
Recent Episodes:
Tune in the first Thursday of each month for new episodes.
APIC Monthly 5 Second Rule Podcast
New Episode:
Recent Episodes:
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The True Cost of an Outbreak
The True Cost of an Outbreak infographic shows how a simple change can have a significant impact on saving time, money, and lives in nursing home facilities. The Healthcare Associated Infection group at Washington State Department of Health made a model using Washington cost data on the use of Enhanced Barrier Precautions. It shows that using fresh gowns and gloves during specific contact activities with patients is cost-effective and easy to implement. Your nursing home can use this strategy to stop the spread of resistant germs, save lives, staff time, and money.
Handout explains the ways COVID-19 vaccines are provided for free
A helpful two-page document explains how insurance covers adults and children who receive the COVID-19 vaccines. Developed by the COVID-19 Vaccine Education and Equity Project, the handout includes brief healthcare coverage requirements for adults, children, and people enrolled in Medicaid, Medicare, TRICARE, and private insurance.
Questions? Email COVID.vaccine@doh.wa.gov.
WA DOH Influenza Update for Week 52 now available!
The weekly summary is available.
Influenza-like illness activity was high during week 52.
- To date, 24 lab-confirmed influenza deaths have been reported for the 2023-2024 season.
- To date, 22 influenza-like illness outbreaks in long term care facilities have been reported for the 2023-2024 season.
- During week 52, 3.9 percent of visits among Influenza-like Illness Network (ILINet) participants were for influenza-like illness, which was above the baseline of 1.9 percent.
- During week 52, 10 percent of specimens tested by WHO (World Health Organization) and NREVSS (National Respiratory and Enteric Virus Surveillance System) collaborating laboratories in Washington were positive for influenza.
- Influenza A and Influenza B were reported to the ILINet surveillance system during week 52.
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 Medicaid Waivers
Two Washington state Medicaid waivers will continue for five more years.
The Centers for Medicare and Medicaid Services (CMS) approved the renewal of two of our state’s 1915(c) waivers, the Community Options Program Entry System (COPES) waiver and the Residential Support Waiver (RSW).
COPES and RSW renewals are effective January 1, 2024 through December 31, 2028. More information on COPES and RSW available.
CDC Resources
Public Health Review Morning Edition
CDC staff Vanessa Iheanachor, Ph.D. and Destani Bezune, MPH spoke with Jerome M. Adams, M.D., MPH, Former U.S. Surgeon General, and Current Executive Director of Health Equity Initiatives at Purdue University about CDC guidance for public health agencies based on its Core Elements of Antibiotic Stewardship framework, and how health equity related to antibiotic stewardship is another issue that needs to be addressed. Listen to their discussion!
Up and Away Campaign
This new Respiratory Virus Season 2023 Toolkit from the PROTECT Initiative includes resources to help educate parents, grandparents, and other caregivers on medication safety and safe medication storage. Resources are available in English and Spanish.
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2024 Preparedness Summit registration now open!
Registration for the 2024 Preparedness Summit, to be held March 25-28, 2024, in Cleveland, Ohio, is now open! The theme is "Public Health, Healthcare, and Emergency Management: Aligning to Address Cascading Challenges." Subscribe to the Preparedness Summit e-newsletter to get the latest news on the 2024 Preparedness Summit.
NACCHO360 Conference registration now open!
The public health community will gather in Detroit, Michigan, July 23-26, to explore our conference theme, "Heard it Through the Grapevine: Public Health Partnerships, Collaboration, and Innovation.” Please note that registrations for PHI*con and NACCHO360 can be purchased separately or bundled together at a discounted rate. Learn more on the PHI*con website, or view registration options.
PHI*Con registration now open!
Registration for PHI*con, which will take place ahead of NACCHO360 on July 22-23, 2024 in Detroit, Michigan, is now open! Aligned with NACCHO360, PHI*con is NACCHO's Inaugural Conference specifically focusing on Public Health Informatics, Surveillance, and IT.
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