HAIIP

Collaboration Meeting

Agenda For March 26, 2026

Table of Contents	Presenter
Introduction and HAIIP Program Objections	Leticia Eastland, HAIIP Program
On-Site Assessments Summary	Leticia Eastland Emilio Barrantes, Operations Manager, Posner Management
Supporting IPs in LTACHs & SNFs	Raquel Torres, Totally Kids Rehabilitation Hospital
Benefits of Admission Testing	Elizabeth Baskaron, IP, Kindred Ontario
Break (10 minutes)	All
Moving Forward- Transition Plan	Jessica Lu, Epidemiologist Leticia Eastland Joseph Pak, Supervising CDI Cynthia Turk, Program Coordinator
All Facilities Letter Summary	John Holguin, Epidemiologist
Discussion Activity	Tanya Martinez, CDI
Questions & Answers	All
Announcements & Roundtable Discussion	All
Additional Resources	All

Introductions and HAIIP Program Overview

Leticia Eastland, Registered Nurse
HAIIP Program, Communicable Disease Section

Healthcare-Associated Infections and Infection Prevention (HAIIP) Program

A single hospital bed lies in the center of the room. Various hospital equipment surrounds the bed.

Program Objectives:

Training: Infection control practices, use of personal protective equipment (PPE), Train-the-Trainer, and current guidelines on managing healthcare-associated infections (HAIs).
Surveillance: Identify and report HAIs.
Mitigation: Rapid response and support for facilities experiencing an outbreak.
Ongoing Support: Provide technical assistance and direct support with healthcare facilities.

On-Site Assessments Summary of Findings

Leticia Eastland, BSN, RN, Registered Nurse HAIIP Program Communicable Disease Section
Emilio Barrantes, Operations Manager, Posner Management

Common Findings- Environmental Services (EVS) Cart Set-up

Disinfecting Wipes VS Microfiber Towels

Appropriate Disinfecting Wipes are an alternative – CONVENIENT!

IV pumps, glucometers, small equipment
Studies show a single wipe disinfects about an area of 3ft x 4ft (coffee table size) before drying, leading to inadequate manufacturer wet contact time.
Is it cost effective to clean and disinfectant an entire resident room using wipes?

Microfiber towels soaked in liquid disinfectant are more effective and are recommended!

Reduce surface bacteria by 99% compared with 33% reduction using conventional materials.
In mop studies, microbial counts dropped by 99% with microfiber mops.

Common Findings- EVS Technique

This is the #1 Repeated Operational GAP!

All facilities need continued education on:

“Cleaning In” zones
“Clean to Dirty” progression
“High to Low” technique
“Outer to Inner” sequencing
Glove changes + hand hygiene between tasks
Disinfection consistency of high-touch surfaces

HAI EVS Room Cleaning Video

(Source: San Diego Couty HAI Program)

EVS Room Cleaning- The 3 Zones

Zone 1 – Shared Equipment and Common Surfaces:

•High-touch surfaces in outer areas of the room, like shared equipment and common surfaces. For example, alcohol-based hand rub (ABHR) dispenser, closets handles, PPE caddies, chairs, light switches, etc.

Zone 2 – Items Touched During Patient Care:

•Area around the bed – not the bed itself. This includes bedside table and drawer knobs, any remotes, telephone, and nightstand surfaces and knobs. Be sure to disinfect underneath tables, along edges, and around all handles.

Zone 3 – Patient and Direct Contact Items:

•The bed – It is considered the dirtiest! Start at the top of headboard to bottom, closest side rails, bed remote, other side rails, attached call bell, and footboard.

Place dirty cloth in collection bag, remove gloves, and use ABHR.

Common Findings- Hand Hygiene

Facilities report hand hygiene monitoring, but:

•Audit data from the facilities are often not provided

•Hand hygiene opportunities at room entry and exit were not consistently performed

•Observed adherence monitoring compliance rates varied from 57%- 100%

•Staff not applying enough alcohol – based hand rub (ABHR) to keep hands wet for at least 20 seconds while rubbing all surfaces

•Limited accessibility to ABHR dispensers observed

A person is washing their hands by receiving soap from a soap dispenser.

Common Findings- Disinfectant Selection

Hospital worker is disinfecting the rails to a hospital bed.

Facilities may have EPA List P products available, but challenges include:

•Confusion about correct EPA-registered disinfectant lists

•Inconsistent use of List P for multidrug-resistant organisms (MDROs)

•Continued use of household disinfectants in some cases

•Need for better understanding of contact (wet) time and label instructions

•Heavy use of spray bottles

•Use of List P wipes to disinfect patient rooms and large surface areas, this does not always achieve the required wet time necessary for disinfection. Based on the videos shown earlier, what would you suggest be used?

Common Findings – Interfacility Transfer Communication

Communication with other facilities:

•When sending and receiving a resident, utilize a transfer communication sheet (such as CDPH’s Healthcare Facility Transfer Form) that contains all pertinent information, including MDRO status.

•Transportation is also notified regarding MDRO status.

Healthcare Facility Transfer Form Comprehensive

Common Findings – Multidrug-Resistant Organism Surveillance

No surveillance and early detection for multidrug-resistant organisms (MDROs):

•No admissions-based MDRO testing for residents transferred in

•No routine Point Prevalence Surveys (PPS)

Petri dish held in a gloved hand showing streaked bacterial colonies growing on agar, with visible lines of inoculation and clusters of white, raised colonies.

Back To Basics

CDPH HAI Program reminds us of the fundamentals of Infection Prevention:

IPC Practices

•Highlights of our IPC practices

EVS
Daily rounds
HH auditing and process surveillance program
MDRO education for staff
On hire and annual infection control competencies

(Source: CDPH Healthcare-Associated Infections Program)

Supporting IPs in LTACHs & SNFs

Raquel Torres, LVN II, Infection Prevention and Control Nurse
Totally Kids Rehabilitation Hospital

Benefits of Admission Testing

Elizabeth Baskaron, Interim Infection Preventionist
Kindred Hospital, Ontario

Break (10 Minutes)

Moving Forward – Transition Plan

Jessica Lu, Epidemiologist
Leticia Eastland, Registered Nurse
Joseph Pak, Supervising Communicable Disease Investigator
Cynthia Turk, Program Coordinator
HAIIP Program, Communicable Disease Section

Investigations/Outbreak Management

•Outbreak-only Investigations
•Reporting Outbreaks:

•Facilities are expected to report outbreaks by sending reports to the HAIIP email: HAIIP@dph.sbcounty.gov or by calling the Communicable Disease Section (CDS) phone number at (800) 722-4794.

•Facilities can refer to the SBCDPH HAIIP website for guidance. Guidelines and resources on investigations, control measures, and management of single cases and outbreaks are being developed and will be shared on the website.