Outbreak Investigation, Public Health and Health Policy

Concurrent Education Session - 60 minutes

2400 - Outbreak Investigation: Hepatitis C Infection Related to Drug Diversion

Primary Speaker(s)

• 

  Patricia Montgomery, MPH, RN, CIC

  Nurse Consultant
  Washington State Department of Health
  Bellevue, Washington

  Nothing to disclose

Second Speaker(s)

• 

  Denise Stinson, MN, RN

  Communicable Disease Control Program Manager
  Tacoma-Pierce County Health Department
  Tacoma, Washington

  Nothing to disclose

Moderator(s)

• 

  Tonya Wagner, BSN, RN

  Senior Clinical Director
  Amsurg
  Moncks Corner, South Carolina

In the last decade, there have been increasing reports of outbreaks of bloodborne pathogens (BBP) and other infections due to healthcare worker diversion of injectable controlled substances. The prevalence of hepatitis C virus (HCV) in the community is increasing in lockstep with the opioid epidemic which has increased drug misuse and addiction in all communities, including among healthcare workers, but the risk of disease transmission as a result of drug diversion remains under-recognized and under-addressed.

In Pierce County, Washington, an outbreak of HCV linked to one emergency department employee has, so far, resulted in the identification of 12 healthcare-associated HCV cases. The likely cause of infection is HCV contamination of drugs intended for patients via unsafe injection practices during drug diversion by the implicated employee.

This session will present an overview of HCV infection and diagnostics; understanding the natural history of infection and laboratory diagnostics is critical for IPs. Participants will gain an understanding of the potential infectious risk from drug diversion and how they can prevent and identify drug diversion, assess the risk to patients, and investigate an outbreak of healthcare-associated HCV.

Participants will get:

• A description of the lessons learned throughout the process and proposed system improvements.
• An overview of the important of collaboration between agencies, such as public health, regulatory agencies, the Nursing Quality Assurance Commission, and law enforcement.
• Tools and resources to perform facility assessments, unique case interview forms, and an improved communication algorithm.

Learning Objectives:

• Describe three best practices to prevent and detect drug diversion.
• Discuss facility and human factor elements that increase risk of hepatitis C virus transmission to patients when drug tampering or diversion is identified.
• Identify three key stakeholders, in addition to infection preventionist, who should be involved in drug diversion investigations.