- Certification in Infection Control and Prevention
- Clostridioides difficile (C-diff)
- Hand Hygiene
- Isolation Precautions
AAMI (Association for the Advancement of Medical Instrumentation)
- AAMI(Association for the Advancement of Medical Instrumentation)
- Professional association for sterile processing (and others in the medical device industry)
- The AAMI standards program consists of over 100 technical committees and working groups that produce Standards, Recommended Practices, and Technical Information Reports for medical devices.
AHA (American Hospital Association)
- AHA (American Hospital Association)
- Best Practices Library
- Quality & Patient Safety
- Infection Control
AHRQ (Agency for Healthcare Research and Quality)
- CUSP – The Comprehensive Unit-based Safety Program (CUSP) combines techniques to improve safety culture, teamwork, and communications, together with a checklist of proven practices.
- The CORE CUSP Toolkit
- Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit
- Toolkit for Antibiotic Stewardship
- Toolkit for Reducing CLABSI in Hospitals
- Toolkit for Reduction of Clostridium [Clostridioides] difficile through Antimicrobial Stewardship
- Toolkit to Improve Safety for Mechanically Ventilated Patients
- Toolkit to Improve Safety in Ambulatory Surgery Centers
- Toolkit to Promote Safe Surgery
- Toolkit to Reduce CAUTI and Other HAIs in LTC Facilities
- Universal ICU Decolonization: An Enhanced Protocol
Antimicrobial Stewardship (AMS)
- Antimicrobial Stewardship (AMS)
- 2017 Antibiotic Use in the United States
- CDC Adult Antibiotic Prescribing Guidelines (Telligen 1-page version)
- CDC Clinician Guide for Collecting Cultures
- CDC Core Elements for Small and Critical Access Hospitals
- CDC Core Elements of Hospital Antibiotic Stewardship Programs
- CDC Core Elements of Hospital Antibiotic Stewardship Programs Checklist
- Rule requiring AMS programs and antibiotic use surveillance (search Section 482.42)
- Joint Commission Antimicrobial Stewardship Standard (MM.05.11.2020)
- National Quality Partners Playbooks: Antibiotic Stewardship in Acute Care
- SHEA Practice Resources for AMS
- This section includes materials and forms, US Academic Medical Centers Online Steward Resources, International Online Stewardship Resources, and other resources
- FDA’s Final Rule for Safety and Effective Health Care Antiseptics; Topical Antimicrobial Drug Products for OTC Use
- APIC (Association for Professionals in Infection Control and Epidemiology)
- APIC is the leading professional organization for IPs
- APIC’s educational programs, products, and services support IP work and its many stakeholders
- APIC collaborates with other professional associations, consumer groups, leaders, and regulatory and accrediting organizations
- APIC Chapters
- Chapters serving Alaska, Oregon, and Washington
- Chapters of APIC:
- Advocate for infection prevention issues
- Create opportunities for networking and communication
- Local chapters provide support at the local level
- Provide leadership and educational opportunities and mentoring
- APIC Online Courses
- Implementation Guides (Provide practical, evidence-based strategies for surveillance and the elimination of infection. Each guide includes online tools and resources.)
ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers)
- ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers)
- ASHRAE – IP Resources
- CDC Fact Sheet on Candida auris (English), (Spanish)
- CDC information about this drug resistant yeast that spreads in healthcare facilities
- CDC Information for Laboratorians and Health Professionals
- CDC Infection Preventionists Fact Sheet (English), (Spanish)
- CDC Information for Patients and Family Members
Cardboard boxes and shipping containers
- Joint Commission Standards FAQ Details on managing cardboard or corrugated boxes and shipping containers
- AAMI Standard ANSI/AAMI ST79:2006
CAUTI (catheter-associated urinary tract infection)
- AHRQ CAUTI Wheel Infographic
- AHRQ Toolkit for Reducing CAUTIs
- APIC Guide to Preventing Catheter-Associated Urinary Tract Infections
- CatheterOut.org Provides clinician and researcher resources with overview, key prevention strategies, and information on provider engagement, implementation and educational tools
- CDC Guideline for Prevention of Catheter-Associated Urinary Tract Infections
- CDC Targeted Assessment for Prevention (TAP) CAUTI Toolkit
- CMS CAUTI Reporting: Operational Guidance for Fulfilling Hospital Inpatient IQR Requirements
- Emergency Nurses Association: CAUTI Prevention in the ED
- SHEA Strategies to Prevent CAUTI in Acute Care Settings
CDC (Centers for Disease Control and Prevention)
- CDC (Centers for Disease Control and Prevention) Healthcare-associated Infection (HAI)
- CDC Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings- Recommendations of the Healthcare Infection Control Practices Advisory Committee.
- CDC Training and Continuing Education Online (TCEO). TCEO offers CEUs for the CDC training.
- CDC/STRIVE Infection Control Training
- CHG (chlorhexidine)
- AJIC A descriptive study of bathing practices in acute care facilities in the United States (American Journal of Infection Control, 2019)
- CHG Bathing Skills Assessment by AHRQ.
- The Lancet Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial.
- Clinical Microbiology and Infection Chlorhexidine-alcohol versus iodine-alcohol for surgical site skin preparation in an elective arthroplasty (ACAISA) study: a cluster randomized controlled trial.
- APIC resources
- CBIC (Certification Board of Infection Control and Epidemiology)
- Predictors of certification in infection prevention and control among infection preventionists: APIC Mega Survey findings (AJIC, 2018)
- Washington State Department of Health/APIC Puget Sound CIC Study Group Meeting
CLABSI (central line-associated blood stream infection)
- AHRQ Toolkit for Reducing CLABSIs
- APIC Guide to Preventing CLABSIs
- CDC Guideline for Prevention of CLABSIs
- CDC Targeted Assessment for Prevention (TAP) CLABSI Implementation Guide
- CMS CLABSI Reporting: Operational Guidance for Fulfilling Hospital Inpatient IQR Requirements
- Improve PICC (multiple links to various resources and guidelines)
- SHEA Patient Education Guide – CLABSI
- Infection Control and Hospital Epidemiology Strategies to Prevent CLABSI in Acute Care Settings
- Needleless Connector Drying Time – How long does it take? American Journal of Infection Control, (American Journal of Infection Control, 2018).
- CLABSI: To use a PICC or not.
- CLABSI: To use a cap or not.
- CLABSI Chlorhexidine bathing skills assessment by AHRQ.
- Infusion Therapy Standards of Practice: A systematic review, (revised 2016). (J Clin Nurs. 2012)
- CDC Surveillance for Blood Stream Infections: central line-associated blood stream infections and non-central line-associated blood stream infections.
Clostridioides difficile (C-diff, formerly Clostridium difficile, and C-diff infection CDI)
- AHRQ Toolkit for Reduction of C. diff through Antimicrobial Stewardship
- Brecher Guidelines Laboratory (Laboratory Diagnosis of Clostridium difficile Infections)
- Bristol Stool Chart
- CDC Targeted Assessment for Prevention (TAP) of C. diff
- NHSN Surveillance for C. difficile, MRSA, and other Drug-resistant Infections
- IDSA/SHEA C. diff Pocket Guide
- IDSA/SHEA Clinical Practice Guidelines for C. diff Infection in Adults and Children
- Know your Poo (a.k.a. Poology)
- Reducing C. difficile Infections Toolkit – GNYHA/UHF C. diff Collaborative
- SHEA Patient Education Guide – C. diff
- SHEA Strategies to Prevent C. diff in Acute Care Settings
- See also WSHA AMS (Antimicrobial Stewardship)
CMS (Centers for Medicare & Medicaid Services)
- Hospital Infection Control Worksheet [document used by surveyors to determine compliance with the Infection Control Condition of Participation]
- State Operations Manual (SOM): Appendix A – Survey Protocol, Regulations and Interpretive Guidelines for Hospitals
- State Operations Manual (SOM): Appendix G – Guidance for Surveyors: Rural Health Clinics
- State Operations Manual (SOM): Appendix W – Guidance for Surveyors: Critical Access Hospitals and Swing-Beds in CAHs
- CAUTI Reporting: Operational Guidance for Fulfilling CMS’s IQR Requirements
- State Operations Manual (SOM): Full Document and All Appendices
- Changes to support U.S. Healthcare System During COVID-19 Pandemic – https://www.cms.gov/newsroom/press-releases/trump-administration-issues-second-round-sweeping-changes-support-us-healthcare-system-during-covid
- FGI (The Facility Guidelines Institute): Guidelines or Design and Construction of Hospitals and Outpatient Facilities.
- The Importance of conducting a comprehensive ICRA (Infection Control risk Assessment) (Abatement Technologies, undated)
- Discontinuing contact precautions for multidrug-resistant organisms: A systematic literature review and meta-analysis, (AJIC, 2018)
- SHEA Expert Guidance: Duration of Contact Precautions for Acute-Care Settings (2017)
- CDC 2007 Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
- WSHA Isolation Precautions
Core Infection Prevention and Control Practices
- Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings – Recommendations of the Healthcare Infection Practices Advisory Committee
CRE (carbapenem-resistant Enterobacteriaceae)
- CDC Carbapenem-resistant Enterobacteriaceae in Healthcare Settings
- AHRQ Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit
Critical Access Hospitals
- CDC Core Elements for Small and Critical Access Hospitals (antimicrobial stewardship)
- CDC has updated the “Human Infection with 2019 Novel Coronavirus Person Under Investigation (PUI) and Case Report Form. More information can be found here:
- CDC Discontinuation of Isolation for Persons with (COVID-19) Not in Healthcare Settings. More information can be found here:
- CDC Staffing Resources and Guidance
- CDC- Ten Ways Healthcare Systems Can Operate Effectively during the (COVID-19) Pandemic
- CDC Testing for Coronavirus (COVID-19) in Nursing Homes. Considerations for use of Test-Best Strategies for Preventing SARS-CoV-2 Transmission in Nursing Homes
- CDC Factors to Consider When Planning to Purchase Respirators from Another Country. More information can be found here:
- Collection and Submission of Postmortem Specimens from Deceased Persons with Known or Suspected (COVID-19). More information can be found here:
- Coronavirus Disease 2019 (COVID-19) Symptoms of Coronavirus
- (COVID-19) Contact Tracing Training, Guidance, Resources, and Sample Training Plan
- Coronavirus Disease 2019 (COVID-19). More information can be found here:
- COVID-19 Case Report Form (Updated 5.5.2020)
- Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19). More information can be found here:
- Important Information About Cloth Face Coverings
- Information for Pediatric Healthcare Providers. More information can be found here:
- Interim Guidelines for Collecting, Handling and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19). More information can be found here:
- Interim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed (COVID-19) in Outpatient Hemodialysis Facilities. More information can be found here:
- Interim Guidance for Homeless Service Providers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
- National Institute for Occupational Safety and Health (NIOSH). More information can be found here:
- National Institutes for Occupational Safety & Health NIOSH PPE Tracker App
- Preparing for (COVID-19): Long-term Care Facilities, Nursing Homes
- Special Considerations for Patients on Home Dialysis
- Strategies for Optimizing the Supply of Disposable Medical Gloves
- CMS released a Toolkit that provides information on federal regulatory and funding flexibilities, healthcare workforce training, licensure, liability protections and matching volunteer workforce needs. More information can be found here:
COVID-19 Testing and Reporting
- CDC Guidance on COVID-19 testing and reporting. More information can be found here:
COVID-19 Visitor Policy Exceptions for End of Life (EOL)
- Visitors are allowed for End of Life situations.
- If there are extended family members, the representative is encouraged to FaceTime or utilize other type of social media to include rest of the family.
- The following information is noted from Ohana Pacific Management Company Policy:
- One visitor each for the following categories:
- End of life
- Labor and Delivery
- For end of life, it can be multiple visitors but only one person allowed in the room at a time.
- Large families would have to trade off persons.
COVID-19 Safety Practices for Critical Infrastructure Workers
- Implementing safety practices for critical infrastructure workers who may have had exposure to a person with suspected or confirmed COVID-19. More information can be found here:
COVID -19 Healthcare Staffing Resources
- For healthcare staffing resources more information can be found here:
Disinfection & Sterilization
- CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities (2008). More information can be found here:
- Tampa General Hospital has strict infection prevention protocols in place, including the use of UVC disinfection, to clean all rooms where infectious disease patients are treated, including (COVID-19) patients. Watch the video below to learn more.
- Mitigating risks of processing reusable medical devices in ambulatory care settings.
Watch the video below to learn more.
- High-Level Disinfection and Sterilization Audit Checklist
- CDC Guideline for Disinfection and Sterilization in Healthcare Facilities
- Selection of the Ideal Disinfectant
- FAQ: Contact time for disinfectants used on non-critical items
- Disinfection Risk Assessment
- EPA-Registered Antimicrobial Products
- UNCHC Endoscope Reprocessing Competency Checklist
- IC Inpatient Audit Tool
- Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19
- Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19
Education – Patient & Family
- For Our Patients and Their Visitors: Help Prevent Infections Endorsed by SHEA, IDSA, CDC, APIC, AHA, The Joint Commission
- CDC “EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections.
- Lessons learned from community environmental cleaning in China.
- Disinfectants are sprayed at every building, road, and street every day.
- Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents.
- The analysis of 22 studies showed that SARS, MERS, and HCoV can persist on surfaces up to 9 days but can be effectively inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide, or 0.1% sodium hypochlorite within 1 minute.
- Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective.
- Basic Principles of Infection Control for EVS Technicians
- PPE and EVS: Keeping EVS Team Members, Patients, and Caregivers Safety
- Chemical Safety for EVS
- Surface Cleaning and Disinfection Procedures and Techniques in EVS
- Minnesota Hospital Association Environmental Services Cleaning Guidebook
- CDC Training and Continuing Education Online (TCEO) Environmental Cleaning Course WB4224
All modules below must be taken to receive CE.
- EC 101: Environmental Cleaning and Disinfection: Principles of Infection Transmission and the Role of the Environment pdf icon[PDF – 53 pages]
Describes the important role that the hospital environment can play in pathogen transmission and shares useful concepts to improve a hospital cleaning and disinfection program.
- EC 102: Cleaning and Disinfection Strategies for Non-Critical Surfaces and Equipment pdf icon[PDF – 52 pages]
Provides an overview of strategies to consider when training staff about cleaning and disinfection policies and procedures, and identifies tools to assist with monitoring and auditing these practices.
- EC 103: Using a Quality Improvement Approach to Improve Environmental Cleaning Practices pdf icon[PDF – 60 pages]
Explores using quality improvement strategies, like Plan-Do-Study-Act (PDSA), to monitor and guide infection prevention improvement initiative
ICAP (Nebraska Medicine)
- What should NOT be stored under sinks?
- Where can I find a list of the cleaning/disinfecting products effective for killing bacteria and viruses?
- Is it true that when a facility has patients/residents with Clostridium difficile or Norovirus, a special type of disinfectant is required after cleaning?
Epidemiology (Principles of) – Self-study course
- Centers for Disease Control and Prevention (CDC)
- This self-study course is based upon the printed text: Principles of Epidemiology in Public Health Practice, An Introduction to Applied Epidemiology and Biostatistics, updated 2012.
ERAS (enhanced recovery after surgery)
- ERAS Society Guidelines
- ERAS is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery.
- ERAS represents a paradigm shift in perioperative care in two ways. First, it reexamines traditional practices, replacing them with evidence-based best practices when necessary. Second, it is comprehensive in its scope, covering all areas of the patient’s journey through the surgical process.
- Reduce care time by more than 30 percent
- Reduce complications by up to 50 percent (ERAS Society Guidelines)
Elsevier COVID-19 Healthcare Hub
- Elsevier COVID-19 Healthcare Hub resource provides toolkits for healthcare professionals such as front-line clinical tools and resources to help deliver excellent care and information to patients.
- More information can be found here: https://covid-19.elsevier.health/?campid=20N17909&utm_campaign
- Topics on the Elsevier COVID-19 Healthcare Hub include:
- Emergency care: Clinical guidelines, drug monographs, and care plans
- Inpatient care: Resources to assist with managing a patient’s condition from treatment through discharge.
- ICU: clinical guidelines and education related to patients in critical conditions, such as ARDS and sepsis.
- Links to the most important leaders working on this pandemic.
European Center for Disease Prevention and Control’s Preparedness for COVID-19
- European Center for Disease Prevention and Control’s Preparedness for COVID-19 provides advice to hospitals that want to be prepared for high-pressure situation caused by SARS-CoV-transmission.
- More information can be found here: https://www.ecdc.europa.eu/en/publications-data/guidance-health-system-contingency-planning-during-widespread-transmission-sars
- British Society of Gastroenterology and Healthcare Infection Society Fecal Transplantation Clinical Practice Guidelines (2018) (Medscape summary)
- Stanford Medicine Fecal Microbiota Transplant: Openbiome Infusate Therapy Guideline
- Article Low Cure Rates in Controlled Trials of Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection: A Systematic Review and Meta-analysis, Clinical Infectious Diseases, April 2019; DOI: https://doi.org/10.1093/cid/ciy721
- ICAP (Nebraska Medicine)
- CDC Guideline for Hand Hygiene in Healthcare Settings, 2002
- WHO Guidelines on Hand Hygiene in Health Care, 2009 Full Guidelines
- Summary of Guidelines
- SHEA Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene, 2014
- Briefing on Hand Hygiene Auditing
CMS Centers for Medicare and Medicaid Services
Organisms’ survival on surfaces
- Joint Communication: Guidance on humidity levels in the operating room (2015)
ICAP (Nebraska Medicine)
- What is the recommendation for cleaning the brushes used when cleaning equipment in the sterile
- What is the recommendation for alcohol purge and forced air dying after endoscope reprocessing?
- What factors should be considered when developing a protocol or policy for cleaning and disinfection of blood glucose meters used on multiple patients?
- Is it sufficient to clean shared nail clippers with alcohol?
- What are the requirements for storing sterile items?
- Should gait belts be assigned per aide/therapist, and used on several residents, or should they be dedicated to one resident, and only used for that resident?
- Are there specific resources for reprocessing of flexible endoscopes?
- APIC Professional Practice: Developmental Path
- APIC Professional and Practice Standards (AJIC, 2016)
- APIC Roadmap for the Novice Infection Preventionist
- APIC Prevention Strategist: Onboarding a Novice IP
Infectious Diseases Society of America
- IDSA Practice Guidelines
- Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances.
- CDC Injection Safety
- Downloadable materials
- FAQs Regarding Safe Practices for Medical Injections (including info on multi-dose vials)
- CDC Safe Injection Practices to Prevent Transmission of Infections to Patients
- TJC Joint Commission
- ICAP (Nebraska Medicine)
- Blunt-Tip Surgical Suture Needles Reduce Needlestick Injuries & the Risk of Subsequent Bloodborne Pathogen Transmission to Surgical Personnel
- Sharps Safety for Healthcare Settings: Brochure, Workbook, PowerPoint slides, and Posters
- Use of Blunt-Tip Suture Needles to Decrease Percutaneous Injuries to Surgical Personnel (2008-101)
- CDC/NIOSH – Stop Sticks Campaign
Institute for Healthcare Improvement (IHI)
- How-to Guide: Prevent Ventilator-Associated Pneumonia (includes vent bundle)
- Plan-Do-Study-Act (PDSA)
- CDC 2007 Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)
- SHEA Expert Guidance: Duration of Contact Precautions for Acute-Care Settings
- WSHA Isolation Precautions
- Discontinuing isolation per CDC on any patient is noted below
The decision to discontinue Transmission-Based Precautions should be made using a test-based strategy or a non-test-based strategy (i.e., time-since-illness-onset and time-since-recovery strategy). Meeting criteria for discontinuation of Transmission-Based Precautions is not a prerequisite for discharge.
- Test-based strategy
- Non-test-based strategy
- Aerosol-Generating Procedures (AGPs) & PPE: High and Low Risk Procedures.
- All PUIs and COVID-19 positive patients should be placed in strict droplet and contact precautions.
- Guidelines and more information can be found here
- Demonstration of effectiveness of good precautions.
- As of March 30, 2020 no staff members at Huoshenshan Hospital had been infected with SARS-CoV-2, indicating that appropriate precautions could effectively prevent infection.
- Social distancing measures
- According to a study published April 14 in Science. The study predicts recurrent winter outbreaks of the virus after the initial, most severe wave.
- To avoid exceeding the capacity of the healthcare system, prolonged or intermittent social distancing may be necessary into 2022, researchers write.
- AORN education on protocol for COVID-19 patients
- AORN provides more information on a protocol for COVID 19-patients undergoing surgery, and reprocessing N95s as well criteria for selection of respiratory protections.
- More information can be found here: https://www.youtube.com/watch
- FDA greenlights a new type of nasal swab for COVID-19
- More information can be found here: https://www.statnews.com/2020/04/16/fda-changes-coronavirus-testing-swabs/
- Importance of recognizing environmental service workers.
- Including EVS in huddles and any safety briefings and recognizing them as essential to the fight against coronavirus.
- More information can be found here: https://www.bbc.com/news/world-us-canada
- COVID-19 positive patients are medically managed until considered not contagious (acute care can be rendered at a hospital OR with either negative pressure or high number of room air changes per hour.
GI Procedures during COVID-19 Pandemic
- AGA Institute Rapid Recommendations for GI Procedures during the COVID-19 pandemic information can be found here: https://www.gastrojournal.org/article/S0016-5085(20)30458-3/pdf
Joint Commission, The (TJC)
Helpful places on their website (no membership required):
- Main TJC Page
- Infection Prevention and HAI Portal
- Standards Interpretation FAQs (you can also sign up for alerts on new FAQs)
- If your question is not found in the FAQs, ask TJC a question here.
- Search by chapter [e.g. Infection Prevention and Control (IC) and Medication Management (MM – antimicrobial stewardship)
- Resource: The JC Big Book of Policies and Procedures for Hospitals – $299 eBook
- Speak Up™ To Prevent Infection
- A new patient safety campaign from The Joint Commission, offers free materials for health care facilities and staff to download and provide to patients and their families, so they can become active in their own care.
Joint Commission: Prerecorded Webinar on Preventing COVID-19 transmission in ambulatory health care.
- Preventing COVID-19 Transmission in Ambulatory Health Care Centers webinar provides an overview of the spectrum of clinical presentations of coronavirus and gives specific suggestions for decreasing the risk of transmission in ambulatory health care settings.
- More information about the webinar can be found here: https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/joint-commission-online
- The Healthcare Laundry Accreditation Council (HLAC)
- Accreditation Standards for Processing Reusable Textiles Please note that you can send a question to HLAC off the main page
- HLAC Standards Checklist – excellent tool to use when visiting or assessing a healthcare laundry facility
- Association for Linen Management
- Joint Commission FAQ Does the JC require employers to commercially launder surgical scrubs and other surgical attire?
- ICAP (Nebraska Medicine) I have been cited for having linen stored inappropriately. What is the recommendation for storing linen?
- Laundering C. difficile patient items
- Textile Rental Services Association (TRSA) o Video: The Six Cs – Handling Soiled Linen (order free flash drive at trsa.org/soiledlinen)
- Joint Commission – Standards FAQs
Medical Waste (waste management)
- Washington Biohazard Waste Regulations
- OSHA Hazardous Waste
- Stericyle (medical waste management company):
- Knowledge Center
- Webinar Medical Waste Segregation 101
- Webinar OSHA 101: Understanding Regulations and Avoiding Penalties
- NIOSH National Institute for Occupation Safety and Health
- Healthcare Respiratory Protection Resources
- NHSN (National Healthcare Safety Network)
- 2018 NHSN Patient Safety Component Manual (definitions for all HAIs reported into NHSN)
- Acute Care Hospitals
There are sections for each of the following:
- BSI – Surveillance for bloodstream infections
- UTI – Surveillance for urinary tract infections
- MDRO/ C. diff– Surveillance for C. difficile, MRSA, and other Drug-resistant Infections
- SSI – Surveillance for Surgical Site Infection Events
- VAE – Surveillance for Ventilator-associated Events
- Surveillance for Healthcare Personnel Vaccination
- NHSN National Healthcare Safety Network (NHSN) Newsletters
- NHSN Training Videos
- NHSN Self-Paced Interactive Trainings
- Guide to the SIR – 2019
Operating Room Attire (ear and hair coverage)
OSHA (Occupational Health and Safety Administration)
- OSHA (Occupational Health and Safety Administration)
- Bloodborne Pathogens Standard
- Bloodborne Pathogens Standard (1910.1030)
- Standard Interpretations
- Tuberculosis Standards (overview)
- OSHA Healthcare-Wide Hazards – Tuberculosis (excellent, easy to use resource)
- Safety and Health Topics
Outbreak Response Guidance
- SHEA Expert Guidance: Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals
- SHEA Outbreak Response Training Program (four free tool kits)
- CDC The CDC Field Epidemiology Manual
Personal Protective Equipment (PPE)
- The latest insights on the importance of PPE programs from OSHA
- Learn how to put on Personal Protective Equipment from AHRQ (video 5 minutes)
- Infection Control Today on Keeping the Supply Chain Intact in the Age of COVID-19. More information can be found here:
- Prices for PPE has increased and Becker’s cites a report published by the Society for Healthcare Organization Procurement Professionals that this increase is due to market forces and price-gouging. More information about the PPE price increase. More information can be found here:
- A webinar by SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) featured N95 Mask Re-Use Strategies.
- Doffing gloves, using the restroom, washing hands, and then donning a new pair of gloves processes.
- More information can be found here: www.pathogendga.com
- COVID-19: Conserving PPE.
- PPE Calculator
- The CDC has a calculator to determine PPE needs health care facilities here:
- The calculator can be downloaded. https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/calculator.html
- Infection Control Today Article: Surgical Masks offer little protection to healthcare workers can be found here:
- CDC guidelines state to wear a gown for AGPs.
- Premier says that ramping up the production of face masks and respirators appears to have affected the material supply needed for gowns. More information from Premier can be found here:
Reuse of Isolation Gowns
- Intermountain Health Care brought re-usable isolation gowns back into circulation for use, and staff only reusing the gowns for each patient encounter and then laundering.
- Lessons learned include: Difficulty to doff and don with a reusable isolation gown without contamination.
- Several attempts failed with ultraviolet testing. Thus, they are only being used for each patient encounter and then laundering.
- Isolation gowns with elastic at the cuffs could not be found useable for staff to doff those without contaminating themselves.
- Recommendation to using washable lab coats, flipped around so the opening is in the back to limit the process with contamination.
- Plastic disposable aprons are utilized by some hospital departments such as dietary and medical records units to preserve PPE for HCWs.
- Dietary aprons which may be usable for some purposes, as they have full sleeves, are waterproof, have tear-away ties and are covered in front fully.
- President Trump says that there are more than 60,000 unused ventilators that will be used for the “Dynamic Ventilator Reserve” program that will be administered by FEMA and HHS.
- The agency announced seven new contracts April 13, 2020.
- HHS has finalized contracts to produce 6,190 ventilators by May 8 and 29,510 by June 1, 2020.
- United Health Group is working with Boston Scientific, Medtronic and the University of Minnesota in Minneapolis in deploying 3,000 emergency ventilators. These are “light” ventilators. More information can be found here:
- NIOSH has updated two Standard Testing Procedures (STP):
- STP-0120—Determination of Positive Pressure—Open-Circuit, Pressure-Demand, Self-Contained Breathing Apparatus Standard Testing Procedure (STP)—has been updated to Revision 1.3, dated February 24, 2020. More information can be found here: https://www.cdc.gov/niosh/npptl/stps/pdfs/RCT-ASR-0120-508.pdf
- STP-0121—Determination of Rated Service Time—Open-Circuit, Demand and Pressure-Demand, Self-Contained Breathing Apparatus Standard Testing Procedure (STP)—has been updated to Revision 1.3, dated March 10, 2020. More information can be found here: https://www.cdc.gov/niosh/npptl/stps/pdfs/RCT-ASR-0121-508.pdf
- US Dept. of Labor’s Temporary Guidance for Respirator Fit-Testing in Healthcare During COVID-19 can be found here:
- For additional guidance, COVID-19 Hospital Preparedness Assessment Tool can be found here:
- OSHA field offices shall exercise enforcement discretion concerning the annual fit testing requirement, 29 CFR § 1910.134(f)(2), as long as employers:
- Make a good-faith effort to comply with 29 CFR § 1910.134;
- Decontamination Methods for 3M Filtering Facepiece Respirators such as N95 Respirators information can be found here: https://multimedia.3m.com/mws/media/1824869O/decontamination-methods-for-3m-filtering-facepiece-respirators-technical-bulletin.pdf
- Ethanol spray damaged the fit and seal of the N95 after 2 rounds of decontamination and it is not recommended to use ethanol spray.
- Respirators treated with UV and heat started to show fit and seal problems following g3 contaminations which suggested masks can be reused twice.
There were no observed failures with the vaporized hydrogen peroxide, suggesting they can be re-used three times. It is the most effective decontamination method for N95. However, anyone who Is using a decontaminated mask should check fit and seal prior to each use.
- Infection Control Today-Don’t Be Fooled: CDC Website Posts Photos of Counterfeit N95 Masks. More information can be found here:
Surgical and cotton masks
- Surgical and cotton masks are ineffective for SARS-CoV-2 virus droplets according to a study in South Korea.
- According to South Korean researchers, in a letter to the Annals of Internal Medicine, they compared both types of masks. When patients coughed into either type of mask, droplets of SARS-CoV-2 were released into the environment.
- This study did not include N95s.
Back orders continue to exist
- Backorders continue to exist for surgical masks, isolation gowns, thermometers and disinfecting wipes, and N95s.
- This is an early warning signal of product shortages that may be on the horizon and need to be planned around.
- From Infection Control Today by Frank Diamond April 1, 2020.
- The FDA suggests that the KN95 are a level 1 mask (surgical/procedural mask).
- Companies design 3D-printed nasal swabs for coronavirus. More information can be found here:
PDSA (see IHI)
- ICAP (Nebraska Medicine)
- How do I go about reviewing infection control policies and bringing them up to date?
Preop Antibiotic Guidelines
- Clinical practice guidelines for antimicrobial prophylaxis in surgery
- Developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA).
Principles of Epidemiology – Self Study Course
- Centers for Disease Control and Prevention (CDC): This self-study course is based upon the printed text: Principles of Epidemiology I Public Health, updated 2012.
- TJC The Joint Commission
- Behavioral Health Care HAI Portal
- CMS Centers for Medicare and Medicaid Services
- State Operations Manual (SOM): Appendix AA – P Psychiatric Hospitals – Interpretive
- Institute for Healthcare Improvement – IHI’s Quality Improvement Essentials includes the tools and templates you need to launch and manage a successful improvement project. Each of the ten tools in the toolkit includes a short description, instructions, an example and a blank template.
- New study on gaps in respiratory protection guidance
- Opportunities to bridge gaps between respiratory protection guidance and practice – ICHE
- Respiratory Fit Test FAQs
Return on Investment, IPC program
- APIC Association for Professionals in Infection Control and Epidemiology
- Infection Prevention-The Unappreciated Return on Investment: Patient Lives and the Bottom Line
- Pennsylvania Patient Safety Authority
- Demonstrating Return on Investment for Infection Prevention and Control
- See also WSHA (Sepsis and Septic Shock )
- WHO How to prevent sepsis infographic
- Sepsis Alliance
- CDC Clinical Resources for Sepsis
Sharps Safety (see Injection Safety)
SHEA (The Society for Healthcare Epidemiology of America)
- For Our Patients and Their Visitors: Help Prevent Infections
Endorsed by SHEA, IDSA, CDC, APIC, AHA, The Joint Commission
- Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals
- SHEA Guidelines and Expert Guidance Documents
Society of Critical Care Medicine (SCCM)
- Home Page Society of Critical Care Medicine (SCCM)
SSIs (surgical site infections)
- AHA Guidance on humidity levels in the operating room (2015)
- AHRQ Toolkit to Promote Safe Surgery
- AHRQ Toolkit to Improve Safety in Ambulatory Surgery Centers
- APIC Infection Preventionist’s Guide to the OR (2018)
- APIC Guide to Elimination of Orthopedic and Mediastinitis SSIs (2010)
- CDC Guideline for Prevention of SSIs (2017)
- SHEA Strategies to Prevent SSIs in Acute Care Settings (2014)
- SHEA Guidance: Infection Prevention in the Operating Room Anesthesia Work Area
- CDC HAN Alert – Contaminated Heater-Cooler Devices Using During Surgery (2016)
- CMS SSI Reporting: Operational Guidance for Fulfilling Hospital Inpatient IQR
- 7S Bundle for Reducing SSIs
- Air Contamination and SSI Risk – Resources from presentation by Maureen Spencer, 2018
Staffing and HAIs, Hospital
- TJC Hospital Staffing and HAIs – A Systematic Review of the Literature, 2018
- AJIC A Systematic Approach to Quantifying Infection Prevention Staffing and, 2018
- Online Statistics Education: A Multimedia Course of Study, Project leader David M. Lane, Rice University.
- p Value, Type I and Type II Errors
- Standard Deviation, Normal Distribution
- Morbidity Frequency Measures: incidence/attack rates, point/period prevalence
- Statistics Definitions – Matching Activity
Sensitivity and Specificity
- Sensitivity and Specificity Explained Clearly (Biostatistics) (12 minutes)
- Medical Statistics: Calculating Sensitivity and Specificity Using a 2×2 Table (< 2 minutes)
- Sensitivity & Specificity (Biostatistics) – Made Extremely Easy to Recall (snout and spin) (1 minute)
- CDC Risk Ratios
Tools and Forms
- ICAP (Infection Control Assessment and Promotion Program), Nebraska Department of Health and Human Services
- The Nebraska ICAP team develops new tools for IPs or provides resources of tools and forms that are already available. They have compiled popularly used tools and forms on their website. These include:
- CDC Infection Control Self-Assessment Tools
- CLABSI Prevention
- CMS Audit Tools
- Device Disinfection/Sterilization
- Environmental Cleaning and Disinfection
- Environmental Rounding
- Hand Hygiene
- Indwelling Urinary Catheters
- Infection Control Committee resource
- Infection Surveillance
- Infection Safety
- Medication Administration
- Observation Tools
- Personal Protective Equipment
- Staff audit documentation tool
- Transfer Form
- Visitor Screening
- And, others
- The Nebraska ICAP team develops new tools for IPs or provides resources of tools and forms that are already available. They have compiled popularly used tools and forms on their website. These include:
VAE (ventilator-associated event)
- AHRQ Toolkit to Improve Safety for Mechanically Ventilated Patients
- AHRQ Daily Care Processes Guide for Reducing VAEs
- AHRQ CUSP Guide for Reducing Ventilator Associated Events in Mechanically Ventilated Patients
- AHRQ VAE Surveillance: Facilitator Guide
- ICU Liberation ABCDEF Bundle
- IHI How-to Guide Prevent Ventilator-Associated Pneumonia (includes vent bundle)
- SHEA Patient Education Resources
- SHEA Strategies to Prevent VAP in Acute Care Settings
- VAEs: What they are are and what they are not (Michael Klompas, Respiratory Care, August 2019, 64 (8) 953-961):
Waste Management (See Medical Waste)
- APIC What You Need to Know about Legionnaires’ Disease
- ASHRAE Guidance on Reducing the Risk of Legionella
- CDC Toolkit Developing a Water Management Program to Reduce Legionella Growth and Spread in Buildings
- CDC Healthcare-associated Infections (includes risk from water; water management; sinks/drains/plumbing, research, opportunisthic pathogens of premise plumbing; and other resources.
- CDC Healthcare-associated Legionella (Legionnaires’ Disease and Pontiac Fever)
- CDC Legionella (including Toolkit for Controlling Legionella in Common Sources of Exposure)
- CDC Special Considerations for Healthcare Facilities
- CMS Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD)
- ICT article on Preventing Waterborne Pathogen Transmission, Infection Control Today, March 2019
- The Role of Water in Healthcare-Associated Infectoins (Brooke K. Decker and Tara N. Palmore, Current Opin Infect Dis. 2013 Aug; 26(4): 345-351): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583640/
- TJC The Joint Commission: Accountability MeasuresNew Water Management Requirements (Effective January 1, 2022)
- WHO interim guidance ‘Water, sanitation, hygiene, and waste management for the COVID-19 virus’. This interim guidance is the second edition and supplements existing infection prevention and control documents by summarizing the latest evidence on COVID-19 in water supplies and sanitation.
WHO (World Health Organization)
WHO provides specific information for IPC
- Core components
- Guidelines and evidence
- Hand hygiene
- Implementation tool
- Injection safety
- IPC and AMR
- Monitoring tools
- Surgical site infection
- Training toolsWHO & COVID-19
- COVID-19 Supply Portal: Frequently asked questions can be found here: https://www.who.int/who-documents-detail/covid-19-supply-portal-frequently-asked-questions
- Weekly update on COVID-19 can be found here: https://www.who.int/who-documents-detail/weekly-update-on-covid-19—1-may-2020
- WHO COVID-19 Situation Reports can be found here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
- WHO has published an interim guidance ‘Water, sanitation, hygiene, and waste management for the COVID-19 virus’. This interim guidance is the second edition and supplements existing infection prevention and controldocuments by summarizing the latest evidence on COVID-19 in water supplies and sanitation.
- WHO has updated their guidance for testing, Laboratory testing strategy recommendations for COVID-19, Interim Guidance, 21 March 2020:
WHO & Standard precautions: Hand hygiene can be found here: https://openwho.org/courses/IPC-HH-en . The WHO 5 Moments for Hand Hygiene diagram is shown below.
- WHO & The Global Outbreak Alert and Response Network (GOARN) has launched a GOARN COVID-19 Knowledge hub.