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Locally acquired Candida auris spreads in Washington
On 1/22/24 the Washington State Department of Health (DOH) learned of an outbreak of Candida auris (C. auris) involving three patients at a healthcare facility in King County. A fourth patient with C. auris was identified at another healthcare facility in Snohomish Co; this person was previously hospitalized at the King County facility. See the following resources for detailed information about the outbreak.
C. auris is an emerging fungus that can cause difficult to control outbreaks in healthcare facilities among patients with certain risk factors -- such as having indwelling devices and a need for long term mechanical ventilation. C. auris is not a risk to most patients in healthcare facilities, to the staff who care for patients, or to the general public.
Public health is working with the impacted facilities, including those that received patients in transfer from the facilities with C. auris cases during the time period when transmission is suspected.
DOH also provides free C. auris screening through the Partners for Patient Safety Program. DOH has many resources to help healthcare facilities and professionals learn more about C. auris and how to prevent transmission.
For any questions about C. auris, please contact your LHJ or the DOH MDRO Team at MDRO-AR@doh.wa.gov
Interim COVID-19 Outbreak Definition for Healthcare Settings
The Department of Health adopted the updated COHRA/CSTE outbreak definition for healthcare on January 1st. The major changes are detailed below, and the full definition is available.
- Changes the threshold for a long-term care outbreak from only one resident case to two resident cases within seven days.
- Changes healthcare personnel only outbreaks from three healthcare personnel to two healthcare personnel and one 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 DOH specific guidance!
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Infection Prevention and Control |
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Let us help you prepare for your upcoming construction!
Are you planning maintenance or construction in your facility this spring or summer? If yes, the Infection Prevention and Control program can help you prepare! One of our Infection Preventionists can come and help you conduct an Infection Control Risk Assessment (ICRA) that is non-regulatory and FREE to you. Going through this process can minimize exposure to harmful particles in construction dust that can have severe health impacts to your residents and staff. Reach out to MDRO-AR@doh.wa.gov for more information.
IPChat 2024!
The Healthcare Associated Infections and Antimicrobial Stewardship section is proud to announce Year three 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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Resources for All Antimicrobial Stewards
Antimicrobial Stewardship Certificate Program Scholarship
Society of Infectious Diseases Pharmacists (SIDP) is offering scholarships to complete their Antimicrobial Stewardship Certificate Program at no-cost. This opportunity is open to nurses, nurse practitioners, physician assistants, microbiologists, laboratory scientists, or physicians who identify as an underrepresented minority, and who live and practice in the U.S. To learn more about this opportunity, visit Antimicrobial Stewardship Certificate or email education@sidp.org with any questions.
Acute Care Stewardship Resources
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. Learn more and apply for funding.
CDC’s NHSN AUR Implementation Resources
NHSN AUR Office hours
The NHSN team is hosting an upcoming office hour session on Thursday, March 7: 12:00-1:00pm PST. The session will start with a brief presentation and the remainder of the hour will be used for Q&A with attendees. 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” with the NHSN AUR module starting in 2024. Review the document!
Long-Term Care Stewardship Resources
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, a guidance document on the topic of PCR urine testing is provided to ensure safety.
Free Patient Communication CE for Nurses and Medical Assistants
This activity is designed to improve communication skills around antibiotic use to help avoid inappropriate prescribing. The activity offers free CE credits for both nurses and medical assistants and is based on the CDC’s 4-part Communication Strategy.
Outpatient Stewardship Resources
Call for Applicants: Prescribing Appropriate Antibiotics for Acute Respiratory Conditions (PAAARC) Project
Unnecessary antibiotics are frequently prescribed for known viral infections, including 75% of adults with acute bronchitis and 45% of children with viral upper respiratory infections. To help improve the use of antibiotic prescribing for respiratory conditions in outpatient settings, the WA DOH has launched the PAAARC toolkit. WA DOH will be providing $15,000 in funding to two healthcare organizations to implement this toolkit and track antibiotic use outcomes.
The application for healthcare organizations is now open - Learn more and apply!
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!
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COVID-19 Vaccination Prevents Thromboembolic Events
 A recent study shows COVID-19 vaccines helped provide protection against COVID-19–related thromboembolic events. Adults 65 years of age or older and adults receiving dialysis are less likely to have a COVID-19-related stroke, heart attack, or blood clot when they had COVID if they had received the bivalent mRNA COVID-19 vaccine. To prevent COVID-19–related complications, including thromboembolic events, adults should stay up to date with recommended COVID-19 vaccination.
COVID-19 Vaccine Prevents Symptomatic Illness
 A recent study shows the updated COVID-19 vaccines provide protection against symptomatic infection, including against currently circulating lineages. Adults who received the updated 2023-2024 COVID-19 vaccine were less likely to have symptomatic COVID-19 infection. Everyone over the age of six months should stay up to date with COVID-19 vaccination.
HAI Epidemiology Outbreaks – A Year in Review
The WA DOH HAI Epidemiology routinely provides consultations and conducts investigations for suspected and confirmed healthcare-associated infections and outbreaks. Consultations are provided to other programs within DOH, LHJs, and facilities when DOH HAI Epidemiology involvement is minimal or healthcare-associated transmission is ruled out. Investigations involve a heightened level of HAI Epidemiology participation, including onsite visits to impacted facilities, remote infection prevention and control assessments, patient notification or call for cases, data analyses, and/or environmental sampling.
The data below show a summary of the consultations and investigations conducted by the HAI Epidemiology team in 2023.
Total Consultations and Investigations by Setting Type
 A recent study shows the updated COVID-19 vaccines provide protection against symptomatic infection, including against currently circulating lineages. Adults who received the updated 2023-2024 COVID-19 vaccine were less likely to have symptomatic COVID-19 infection. Everyone over the age of six months should stay up to date with COVID-19 vaccination.
Primary Organism/Disease in Investigations by Setting Type
 This table shows the primary organism or disease identified, separated by healthcare setting type. Legionella species were identified in the most investigations across all healthcare settings. In skilled nursing facilities, COVID was the most identified pathogen, followed by Legionella species. In acute care, there were six different organisms or diseases identified in the seven investigations, with Legionella species being the only organism identified in more than one investigation in acute care.
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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!
Check out our new Cleaning vs. Disinfecting job aid. Available in our modules and on our website!
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
Frontline Infection Prevention Champion Training Programs!
The WA DOH is now highlighting the Frontline IP Champion Training Program! When a healthcare provider training program implements the Project Firstline online IP Training Modules and other Project Firstline education and training materials into their curriculum, they will be featured on our website and receive a certificate.
We currently have six public and private training programs utilizing the Project Firstline modules and resources!
- Crystal Point CNA Training School
- Excel Health Careers Training
- Green River College
- Med Smart Academy
- Medical Professions Academy Woodinville High School
- Tri-Tech Skills Center: Pre-Physical Therapy, Dental, and Certified Nursing Assistant programs
Involve your training program today!
Don’t worry, we are still offering our Frontline Infection Prevention Champion Facility program. Find out more!
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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NHSN Epidemiology Email
The NHSN Epidemiology Team has a dedicated 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.
Reminder! 2023 Annual Facility Survey is due March 1, 2024
The annual facility survey is required for all facilities reporting HAIs in NHSN. It is optional for LTCFs, unless you report HAIs in NHSN. However, we strongly recommend that you complete the survey. Please reach out to NHSNepi@doh.wa.gov for assistance or questions.
 Bimonthly 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 the NHSN Epi Team 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:
- Mar 14, 2024
- Apr 11, 2024
Please reach out to the NHSN Epi Team for more information.
NHSN Support Services for SNFs
For a more comprehensive list of NHSN support options the HAI Epi Team can provide to skilled nursing facilities, see the NHSN Support and Technical Assistance for Skilled Nursing Facilities flyer.
NHSN Reporting Updates and Trainings
Long-term Care Facilities (LTCFs) continue to collect cumulative 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.
Reporting Influenza and RSV Cases and Vaccination for Long-term Care Facility Residents: Long-term care facilities (LTCF) are strongly encouraged to report resident 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 through the COVID-19/Respiratory Pathogens modules. LTCFs should continue to follow reporting requirements for submitting COVID-19 data information for residents and staff.
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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
Recent Episodes:
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WA DOH Influenza Update for Week 5 now available!
The weekly summary is available.
State Summary
- Influenza-like illness activity was low during week 5.
- To date, 78 lab-confirmed influenza deaths have been reported for the 2023-2024 season.
- To date, 52 influenza-like illness outbreaks in long term care facilities have been reported for the 2023-2024 season.
- During week 5, 2.3 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 5, 8.7 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.
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 2024 Adult Family Home Winter Forum
This is an opportunity to meet your Field Managers and Regional Administrators, discuss important topics of provider interest, hear regulatory updates, receive education, and learn opportunities for quality improvement. Most importantly, you have the chance to come together and strengthen communication and understanding of our shared mission and partnership of quality care and service delivery in adult family homes for our most vulnerable clients and residents.
We are pleased to partner with the Adult Family Home Council to bring this forum to you. Educational themes are 1) AFH upcoming surveys and 2) inclement weather impacts. The AFHC offers CEUs.
Registration is free and now open to all AFH providers. We hope you will join us on 2/29/2024 from 1:00-2:30pm PST!
Nursing Home Provider Expectation to Follow Public Health Guidance
A letter to NH administrators is now available.
CDC Resources
Diagnostic Testing and Treatment Guidelines for COVID-19 and Influenza
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Lake WA Technical College - Infection Control Course!
Lake WA Technical College is offering an infection control course from April 1st -June 12th, every Thursday evening from 6:30-8:30 PM. This course provides an overview of the role of the infection prevention and control program in healthcare. Students will identify infectious disease processes commonly used to identify healthcare-associated pathogens, design and assess surveillance systems to be used in the healthcare setting, and then demonstrate how to collect, compile, and interpret surveillance data. Students will work on developing strategies specific to the settings where they work.
You don't need to be an LWTC student to register for the class!
University of Washington DNP PHSL recruitment for 2024-2025!
Applications for the Population Health and Systems Leadership DNP are open now through May 1st for Fall 2024 at the University of Washington in Seattle. Our DNP in Population Health and Systems Leadership program is unique in that it develops nursing leaders to be change agents at the population- and system-levels and to address unjust systems that perpetuate poor health. Our graduates work in leadership roles in a variety of settings, including hospitals, health departments, nonprofits, and tribal organizations. Topics covered in classes include program planning/evaluation, community assessment, evidence-based practice, epidemiology, and health services, systems, and economics. As a graduate of our DNP in PHSL, you will have the opportunity to directly influence how people and communities experience health care and health-adjacent systems at the highest levels.
Upcoming Information Sessions can be found on our website. Learn more about DNP PHSL and consider joining us!
We are currently accepting applications for Fall 2024 and would be happy to discuss with any interested nurses. For additional information please email one of the following of us directly:
General questions: asknursing@uw.edu
Admission/application questions: Simone Nelson
Population health track curriculum questions: Betty Bekemeier
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