A Department of Health team of infection control experts and epidemiologists will visit University Hospital and four pediatric long-term care facilities in November to conduct training and assessments of infection control procedures, Commissioner Dr. Shereef Elnahal announced today.
“Facility outbreaks are not always preventable, but in response to what we have seen in Wanaque, we are taking aggressive steps to minimize the chance they occur among the most vulnerable patients in New Jersey. Pediatric long-term care facilities such as the Wanaque Center, and University Hospital’s neonatal ICU, take care of extremely medically fragile infants and children. We will deploy our Infection Control Assessment and Response (ICAR) team to Wanaque and all similar facilities, as well as University Hospital,” said Dr. Shereef Elnahal. “ICAR teams are experts in infection control, conducting 160 voluntary, on-site assessments in hospitals, long-term care and outpatient facilities, dialysis centers, and even Ebola treatment units. They have also hosted educational webinars on infection control.”
The team will visit University Hospital, Wanaque Center for Nursing & Rehabilitation in Haskell, Voorhees Pediatric Facility in Voorhees, and Children’s Specialized Hospital in Toms River and Mountainside. The Department reached out to the facilities last week to schedule visits in November.
State Epidemiologist and Assistant Commissioner Dr. Tina Tan said the multi-disciplinary team has previously visited two of the four pediatric facilities, Voorhees in May and Wanaque in 2016, per the facilities' requests.
The ICAR conducts voluntary, non-regulatory assessments of infection prevention practices and takes a collaborative approach to highlight and share what facilities are doing well and identify opportunities to improve. The assessments focus on prevention of health facility-acquired infections and breaches of infection control through adherence to best practices and state and federal requirements.
Over the past three years, the ICAR team has performed 160 on-site assessments at 62 long-term care facilities, 32 dialysis centers, 33 acute care hospitals, 30 outpatient facilities and three regional Ebola treatment units. The team has also done training webinars on infection prevention issues such as blood glucose monitoring and medication preparation. The team is continuing to develop education resources for use by facilities across the state.
The Department’s Communicable Disease Service, which houses the ICAR team, also works closely with the Department’s Division of Health Facility Survey and Field Operations. The collaboration among these teams, has been recognized by the Centers for Medicaid and Medicare (CMS) and the Association of Health Facility Survey Agencies. The collaboration among the teams on developing an algorithm to formalize reporting of infection control breaches during facility inspections and a partnership in safe injection education received recognition from the Association of Health Facility Survey Agencies. These efforts were also commended by CMS for ensuring that survey staff have the most current infection control information and resources accessible to them.
In addition to enforcement of the Department’s health care facilities standards, the Division also supports education of healthcare professionals to enhance care quality. The Division uses funds collected through penalties to sponsor long-term care facility staff education. These funds come from the civil money penalties that CMS may impose against skilled nursing homes.
Since October 2016, $102,915 has been dedicated to educating 212 nursing home staff in infection control through a partnership with New Jersey Hospital Association and the Northern & Southern NJ Chapters of Association for Professionals in Infection Control and Epidemiology. The training makes a significant contribution to nursing home resident’s quality of care and facilities’ infection prevention control practices. It also increases nursing homes’ ability to affect changes in procedures, which can reduce unnecessary hospitalizations due to infections.
Commissioner Elnahal outlined the ICAR Team initiative to the Chairs of the Senate Health, Human Services and Senior Citizens Committee, Assembly Health and Senior Services Committee, Assembly Human Services Committee and Assembly Women and Children Committee and received their support:
“I am encouraged by the proactive approach Commissioner Elnahal is taking to ensure the well-being of medically-fragile children cared for by facilities throughout NJ,” said Sen. Joseph Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee. “The Department continues to be forthcoming and keeps me regularly apprised of the progress of their investigation. I'm thankful that he agrees with me that his department should carry out this education and training program in facilities like Wanaque and ensure that they are complying with all infection control protocols. I am confident in the capability of the professionals in the Department of Health to get to the bottom of this terrible outbreak and explain to us how this happened and more importantly recommend ways in which it can be prevented in the future. I will continue to work closely with the Commissioner to monitor the situation. My prayers and thoughts remain with the families of the children who succumbed to this outbreak and the children who are currently being treated.”
Assemblyman Herb Conaway, Jr., Chair of the Assembly Health and Senior Services Committee, stated, “We applaud the Department of Health and its Infection Control Assessment and Response (ICAR) teams for proactively assessing facilities that are home to many medically fragile children and elderly persons. Those teams employ best practices to improve prevention efforts beyond regulated standards. Commissioner Shereef Elnahal and the Department of Health are taking the right steps in ensuring health care excellence at Wanaque and other facilities across the state.”
Assemblywoman Joann Downey, chair of the Assembly Human Services Committee, said she is confident in the Department of Health’s response. “I have been in communication with the Department to help ensure that not just Wanaque, but other facilities in the State serving this population are on high alert for surveillance, detection, reporting and response to this serious threat to children’s lives and to ensure that everything is being done to prevent any further spread of infection and another death from occurring.”
"I fully support the important work being undertaken by the Infection Control Assessment and Response team," said Assemblywoman Gabriela Mosquera, Chair of the Assembly Women and Children Committee. "The tragedy we learned about last week at The Wanaque Center for Nursing and Rehabilitation makes it clear the State must do everything within its power to ensure staff and administrators at our pediatric long-term care facilities, University Hospital and all our health care facilities fully understand and comply with infection control procedures and protocols. This is literally a life-saving endeavor."
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