ICCS Infection Prevention & Control Newsletter: July 2021

This issue covers some of the most significant news from July. Topics include CMS penalties, vaccine reporting, high-level disinfection, OSHA, Delta variant, vaccine mandates, and outpatient antibiotic use.

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CMS Per-Incident Penalties for Providers Soar — And Could Be Headed Higher — The total amount of fines CMS has collected through per-incident penalties has increased more than eight-fold from 2016 to 2020, and the figure is projected to reach new heights by the end of 2021.

Burdensome Vaccine Reporting Requirements Overwhelming Providers Dealing With COVID Outbreaks, Staff Shortages — Short-staffed long-term care providers are struggling to respond to COVID-19 outbreaks at their facilities and comply with a federal requirement to report COVID vaccination data.

How to Document the High-Level Disinfection Patient Connection — Insight from Phenelle: "Endocavitary or ultrasound probes have been highlighted for many years as an important component of medical device reprocessing. These devices require high-level disinfection, and strict use of manufacturers' instructions is imperative to the safety and wellbeing of patients. This article highlights the importance of monitoring for appropriate disinfection and tracing the individual probe used to a specific patient. The ability to link a specific piece of equipment or device to each patient allows for confirmation of high-level disinfection and a much smoother process should an issue arise."

Too Much, Too Late: Health Groups Pan OSHA Rule on COVID Precautions — It comes as no surprise to see this reaction to the new rule from the Occupational Safety and Health Administration (OSHA) intended to protect healthcare workers from COVID-19.

Larger Staff Size Increased Risk of COVID Outbreaks, Study Finds — Operators that had more staff coming in and out of a skilled nursing facility, while maintaining comparable direct care hours to those with fewer staff, had increased susceptibility to COVID-19 outbreaks last year.

Unvaccinated Nursing Home Staff in the Hot Seat as CDC Investigates COVID-19 Breakthrough Cases — Several Colorado senior care facilities are at the center of a CDC COVID-19 investigation, and public health officials there are zeroing in on unvaccinated staff as the cause of breakthrough cases.

Why the Delta Variant is Hyper-Contagious: A New Study Sheds Light — After months of data collection, scientists agree: The delta variant is the most contagious version of the coronavirus worldwide.

V.A. Issues Vaccine Mandate for Health Care Workers, a First for a Federal Agency — Employees who provide direct patient care have eight weeks from the issuing of the mandate to get inoculated against the coronavirus or face penalties including possible removal.

National Organizations in Epidemiology and Infection Prevention Say COVID-19 Vaccines Should Be Required for Healthcare Personnel — Seven leading organizations issued this important joint statement, including APIC, SHEA, and IDSA.

AMA, 56 Other Groups Back Mandatory COVID Vax for Healthcare Workers — Major medical groups joined the call for healthcare and long-term care employers to require vaccination.

Nurses Urge CDC to Reinstate Universal Masking to Reduce the Spread of COVID-19 and Protect RNs, Essential Workers, and the Public — The National Nurses United sent a letter to CDC, urging the agency to update its Covid-19 guidance and reinstate "the recommendation for everyone to wear masks in public or in physical proximity to others outside their own household."

Urine Culture Stewardship Linked to Reduced Catheter Infections — Researchers reported that a urine culture stewardship initiative at a teaching hospital reduced overuse of urine cultures and was associated with a significant decline in catheter-associated urinary tract infections.

VA Study Spotlights Decline in Outpatient Antibiotic Use — It's encouraging to see improvement in this critical yet often overlooked area, but as the story notes, there's much work left to be done.

ICCS Infection Prevention & Control Newsletter: June 2021

This issue covers some of the most significant news from June. Topics include OSHA, respiratory program strategy, TB outbreak linked to spinal surgeries, C. diff, hand hygiene, and antibiotics.

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OSHA Limits Long-Awaited Virus Safety Rule to Healthcare — The first nationwide emergency workplace safety rule, requiring healthcare employers to protect workers against on-the-job COVID-19 infection, was published. Qualifying providers have until July 6 to comply with most provisions.

The Roadmap to Respiratory Season Success in Non-Acute Settings — In this McKesson e-book, learn key pillars in formulating a successful respiratory program strategy. The resource features insight from ICCS President Phenelle Segal, RN, CIC, FAPIC, for the two chapters on infection prevention.

CDC Investigating TB Outbreak Linked to Spinal Surgeries — The investigation concerns Aziyo's FiberCel bone repair putty, distributed by Medtronic.

2021 Focused Update Guidelines on Management of Clostridioides Difficile Infection in Adults — IDSA and SHEA published new clinical guidelines for C. diff in adults.

Phenelle Segal to Present on COVID-19's Impact on ASCs — Phenelle will be presenting at the Florida Society of Ambulatory Surgical Centers (FSASC) Annual Conference and Trade Show. Her session on "How COVID-19 Has Impacted ASCs: Lessons Learned and Looking Forward" is scheduled for July 14 from 1:00 p.m. – 2:30 p.m.

California Considers Increasing Number of Nursing Home Inspections — Long-term care providers in California could be subject to more visits from inspectors as the state ponders changes to its nursing home inspection system. We'll be watching what's happening in California and seeing if this is a trend that extends to other states.

As New Leader Takes CMS Helm, Look for Action on SNF Waivers and Infection Control Policies — CMS begins the summer with a new administrator. Soon, the skilled nursing industry will begin to see how this new agency leader will shape nursing home policy and regulation.

How to Guard Against Lapsed Hand Hygiene Compliance — Infection preventionists and hospital administrators must continue pushing for better hand hygiene compliance once healthcare workers stop worrying as much about their own safety, a study states.

Toolkit To Improve Antibiotic Use in Long-Term Care — AHRQ has released a new toolkit to help LTC facilities improve their antibiotic use.

Healthcare Leaders Call for National Focus on Preventing Hospital-Acquired Pneumonia — A group of healthcare leaders has published a national call to action to prevent non-ventilator-associated, hospital-acquired pneumonia (NVHAP).

Increased Interseasonal Respiratory Syncytial Virus Activity in Parts of the Southern United States — CDC has issued a health advisory concerning the spread of RSV cases throughout the south.

AMA: 96% of Doctors are Vaccinated Against COVID-19 — The American Medical Association said 96% of "practicing physicians" have been fully vaccinated for COVID-19.

Phenelle Segal to Present on COVID-19's Impact on ASCs

ICCS Founder Phenelle Segal, RN, CIC, FAPIC, will be presenting at the Florida Society of Ambulatory Surgical Centers (FSASC) Annual Conference and Trade Show in Orlando on Wednesday, July 14.

Phenelle’s session on “How COVID-19 Has Impacted ASCs: Lessons Learned and Looking Forward” is scheduled for 1:00 p.m. – 2:30 p.m. It is described as follows: “COVID-19 has forever changed healthcare and this presentation will highlight ongoing practices in ambulatory surgery centers one year later as we adapt to the ‘new norm.’ Core principles of perioperative infection prevention and lessons learned will be addressed, as we move forward in this everchanging environment.”

To learn more about the event, click here. Attendees interested in arranging an on-site meeting with Phenelle should contact ICCS.

ICCS Infection Prevention & Control Newsletter: May 2021

This issue covers some of the most significant news from May. Topics include Joint Commission standards, vaccinate mandate, nursing home and SNF surveys, SHEA guidance, and antibiotic stewardship.

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Joint Commission Infection Control Standards Among the Most Challenging in 2020 — The Joint Commission issued its top 5 most challenging requirements for 2020. Once again appearing on multiple programs' lists: infection control standards.

Phenelle Segal on the Healthcare Worker COVID-19 Vaccine Mandate Conundrum — Read the position of ICCS Founder Phenelle Segal on this widely debated topic.

Pandemic Reawakens Urgency About Infection Control and Prevention — ICCS's Phenelle Segal is one of the sources featured in this Nurse.com article on the pandemic's effects on infection control and prevention.

Skilled Nursing Facility Surveys Skyrocket During Pandemic — Federal data indicates the number of surveys conducted nationwide has risen 132% since 2020 and there has been a "dramatic increase" in infection control surveys and more immediate jeopardy-level citations.

'High Stakes' as Providers Still Face Brisk Infection Control Surveys, Brace for Return of Standard Inspections — An analysis shows that when nursing homes are dinged for infection-related deficiencies, they are facing stiffer penalties than they do on typical surveys.

Healthcare Personnel Must Continue SARS-CoV-2 Prevention, Even as Community Guidelines Relax — Sound guidance from the Society for Healthcare Epidemiology of America.

Cleveland Clinic Finds 99.7% of Caregivers Who've Recently Tested Positive for Covid-19 Weren't Fully Vaccinated — Powerful data reinforces the effectiveness of vaccines for preventing symptomatic infections, severe illnesses, and hospitalizations.

AAP: Masks Encouraged for Camp, Child Care, School to Prevent COVID-19 — The American Academy of Pediatrics issued updated COVID-19 clinical interim guidance.

Implementation of Core Elements of Antibiotic Stewardship in Nursing Homes — Nursing homes reported substantial progress in antibiotic stewardship implementation from 2016 to 2018.

Veterinarians' Smartphones, Tablets Contaminated With Staphylococci — New research shows the importance of cleaning smartphones and tablets regardless of whether you're caring for people or animals.

Phenelle Segal on the Healthcare Worker COVID-19 Vaccine Mandate Conundrum

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In response to the ongoing debate about whether healthcare workers should be mandated to take the COVID-19 vaccine, Phenelle Segal, RN, CIC, FAPIC, president and founder of Infection Control Consulting Services (ICCS), states the following:

"Since COVID-19 emerged, ICCS has focused significantly on supporting nursing homes.  While I believe there is merit to the COVID-19 vaccine being mandated, I understand why nursing homes are not yet taking those steps. It is a complex situation as I have learned from engaging in conversation with administrators.

"There is a critical shortage of nursing staff, particularly aides. When staff is lacking, care may be compromised. This is magnified in the COVID environment. Mandating the vaccine may drive staff away from the nursing homes, making recruitment and retention more difficult. While we have seen numerous employees continue to test positive, especially those unvaccinated or partially vaccinated, the highly successful vaccination of the elderly, particularly those in nursing homes, is resulting in a significantly lower incidence of illness and positivity among residents. Fully vaccinated staff are mostly asymptomatic. A significant sign of vaccine success is the overall lack of disease that leads to hospitalization and death in the elderly.

"Several factors contribute to vaccine hesitancy, including lack of understanding and education. Focusing efforts on educating the staff about the value of the vaccine for them personally as well as the residents is paramount.

"A higher priority in nursing homes should be performing infection control and prevention processes correctly. These practices ultimately keep residents safe during pandemic and non-pandemic times."