Infectius Diseases-HAI, Infectius Diseases New Jersey Department f Health, Cmmunicable Disease Service/Infectius and Zntic Disease Prgram Trentn, New Jersey Assignment Descriptin NJDOH prvides public health services t ver nearly nine millin New Jersey residents. The fellw will wrk with the NJDOH Cmmunicable Disease Service (CDS), which is cmprised f three areaspecific prgrams (Infectius and Zntic Diseases, Reginal Epidemilgy Prgram, and Vaccine- Preventable Diseases). The fellw will be part f the HAI/AR team within the Infectius and Zntic Disease Prgram. CDS prvides guidance t lcal health departments and health care facilities statewide regarding rutine investigatins f reprtable cmmunicable diseases and utbreaks as well as public health emergencies, including emerging infectins and events related t biterrrism. CDS has apprximately 90 staff members wh represent a range f expertise, including physicians, nurses, epidemilgists, health educatrs, and veterinarians wh are available t the fellw fr cnsultatin and/r cllabratin. The fellw will have the pprtunity t wrk with the State HAI Crdinatr and partner with staff in the Divisin f Healthcare Quality Assessment respnsible fr quality metrics f HAI reprting and HAI preventin practices. Day-t-Day Activities The Fellw wuld be an integral part f the HAI/AR team. The fellw's anticipated day-t-day activities wuld include wrk n lng-term analytic prjects that they selected r designed as well as active participatin in acute utbreak investigatins r ther skill-enhancing activities. Examples include: Lng-term analytic prject cmpnents, such as epidemilgical data cllectins, analysis, and reprt writing Acute utbreak investigatins, which wuld ptentially invlve field investigatins (site visits), develping and/r administering questinnaires, develping databases and linelists, analyzing data, and participating in cnference calls with lcal, federal, and ther state public health agencies Investigatin f reprted infectin cntrl breaches in healthcare facilities, including diversin f injectable medicatins Investigatin f HAI related reprts, including viral hepatitis r ther pathgens Respnd t inquiries frm LHD r the public regarding infectin cntrl r utbreak cntrl measures
Capacity building (educatin, technical assistance) and engagement f Tier II and III health care facilities n infectin cntrl and best practices The Fellw will meet at least weekly with ne r bth mentrs. The Fellw als has the ptin t meet the State HAI Crdinatr and AR Crdinatr n a regular basis The Fellw will als have the ptin t participate in lngstanding meetings and existing prgrams with HAI and AR-fcused initiatives; the Fellw may chse t develp analytical prjects stemming frm these existing prgrams. Examples include: Participatin in bi-weekly meetings with CDS epidemilgists regarding current investigatins/utbreaks Participatin in regular meetings with reginal (i.e., based at lcal health departments) epidemilgists regarding current investigatins/utbreaks and lectures n tpics in public health Participatin in the NJDOH Drug Diversin cllabratin, which ffers an annual cnference as well as quarterly cnference calls t discuss the needs at healthcare facilities regarding drug diversin preventin, detectin and respnse Participatin in internal and external Antibitic Stewardship Cllabrative meetings. Participatin in the HAI Subcmmittee fr Infectin and Assessment Cntrl and Respnse (ICAR) quarterly meetings, which is respnsible fr guiding assessments in infectin cntrl capacity thrughut the state In additin t day t day activities, the Fellw will als be encuraged t identify ther activities that can help them develp r imprve their skill sets and r prmte prfessinal develpment, including: Oral and pster presentatins t the public and health prfessinals at lcal/reginal r natinal cnferences r training sessins Access t statewide in-persn and nline public health trainings. Examples Include: SAS refresher curse Public Health Media Training Cmmunicable Disease Investigatr Training Intrductin t Lgic Mdels APIC Infectin Cntrl Curse
Ptential Prjects Surveillance Activity Surveillance fr Antimicrbial Resistant Organisms 1. Research available data regarding state antibigrams that highlights resistance patterns thrughut the state. 2. Develp a NJ-specific electrnic state antibigram system fr acute care hspitals r ther types f healthcare facilities t submit t the NJDOH. 3. Assess Electrnic Labratry Data reprted t NJDOH fr antibitic susceptibility testing infrmatin and develp systems t prduce autmated state r reginal antibigrams r analyze reprted data in near-real-time. 4. Analyze resistance data reprted int CDC's NHSN system by healthcare facilities at the lcal/cunty level. This culd include frequency analysis, determining variatin f resistant rganisms by regin, r gespatial analysis. 5. Develp and administer survey t lng-term care facilities, utpatient facilities, r ther type f healthcare facility t determine infectin cntrl practices, antimicrbial stewardship activities, r ther surveillance, lab, disinfectin/sterilizatin activities. 6. Develp and administer survey t determine rates and infectin cntrl practices f currently nnreprtable MDROs, such as MDR Acinetbacter, Carbapenem-Resistant Enterbacteriaceae (CRE), and Pseudmnas aeruginsa. 7. Analyze epidemilgic and labratry data frm the surveillance testing perfrmed by NJDOH as part f the CDC Antibitic Resistance Labratry Netwrk (ARLN). 8. Cllect and analyze epidemilgic, labratry, r healthcare-facility data cllected thrughut Candida auris utbreak investigatins. 9. Assess the Antibitic Stewardship practices and prgrams instituted by NJ healthcare facilities fllwing targeted infectin cntrl assessments r the institutin f federal mandates fr Antibitic Stewardship prgrams.
Surveillance Evaluatin Evaluatin f NHSN fr HAI data Evaluate HAI data reprted int CDC's NSHN system in acute care hspitals thrughut New Jersey. These data may include MRSA, C. difficile, CLABSI, CAUTI events. Fellws culd chse t perfrm data validatin r gespatial analysis as part f the evaluatin, as these data are self-reprted by healthcare facilities. Examples f prjects using data frm NHSN data include: 1. Using NHSN data, assess the impact f staff influenza vaccinatin rates n influenza infectins in healthcare wrkers f acute and lng term care facilities. 2. Using NHSN data t assess the relatinship f adherence t active surveillance testing requirements and infectin rates f MRSA in acute care hspitals. 3. Cmbining NHSN data with state-level data n reprting healthcare facilities, assess pssible intrinsic and extrinsic factrs that may be assciated with infectin rates reprted by the facility. A previus CSTE HAI Fellw did a validatin study f the MRSA LabID event NHSN data which prvided key infrmatin t hspitals n their reprting as well as MRSA clnizatin rates. NJ has the need fr further NHSN data validatin t be perfrmed. NJDOH is als in the prcess f acquiring access t NHSN data reprted by nursing hmes in New Jersey. Validatin f HAI data reprted by nursing hmes including C. diff and CAUTI data will then als be pssible. Majr Prject Infectin Cntrl Assessment and Respnse (ICAR) Prjects NJDOH was ne f the states which applied fr and received ELC Ebla Supplemental Funding frm CDC that tasks the state with assessing infectin cntrl capacity thrughut the state. The fellw will assist in analyzing and evaluating data frm the infectin cntrl assessments being perfrmed as part f the ELC Ebla/ICAR Supplement grant activities. The HAI/ICAR team is currently using CDC standardized interview tls and direct bservatin tls, t assess infectin cntrl capacity in acute care, lng-term care, dialysis, and ut patient settings. As infectin cntrl capacity is assessed at varius facilities, the fellw will help identify areas that are gaps in infectin cntrl and assist in the mitigatin f the gaps. Infrmatin frm the data cllected and analyzed will assist in the develpment f training fr healthcare wrkers. The fellw can assist in the develpment and implementatin f the training in increase infectin cntrl acrss the data.
Additinal Prject Evaluatin f NJ Cmmunicable Disease Reprting and Surveillance System Depending n the interest f the fellw, perfrm a surveillance evaluatin n a reprtable disease f the fellw's chsing in the state's Cmmunicable Disease Reprting and Surveillance System (CDRSS). CDRSS captures bth persn-entered and electrnic (ELR) disease reprts. Preparedness Rle 1. Participate in state BiWatch and FBI meetings/trainings. 2. Fellw will be assigned after hurs emergency n call duty fr the NJDOH twice a year. 3. In the event f a public health emergency, the fellw wuld be part f the CDS respnse team (which includes sub-teams in the areas f business cntinuity, Emergency Call Center, cmmunicatins, epidemilgy/surveillance, and data management). In the past, this has included Influenza H1N1, Ebla, and Lassa fever respnse. Additinal Activities 1. Investigatins f utbreaks - bth healthcare and cmmunity assciated. The Fellw will have numerus pprtunities t lead and/r participate in utbreak investigatins; CDS receives ver 300 reprts/year f cmmunicable disease utbreaks f varius etilgy. 2. Investigatin int cases f nvel resistance identified by state and reginal testing within the CDC Antibitic Resistance Labratry Netwrk (e.g., plasmid-mediated clistin resistance). 3. Participate in infectin cntrl assessment visits being perfrmed by the state in varius healthcare settings as part f the ELC Ebla/ICAR Supplement grant activities. Mentrs Primary Edward Lifshitz MD,FACP Medical Directr Secndary Rebecca Greeley MPH Infectius Disease Team Lead