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October 2008
Vol. 18 No. 10
Top Stories
SHEA, IDSA, and Partners Publish Strategies to Prevent Health Care-associated Infections
Diana Olson

For the first time, the Society for Healthcare Epidemiology of America (SHEA), IDSA, and three other leading health care organizations have come together to publish practical, evidence-based strategies to help hospitals prevent six of the most important health care-associated infections (HAIs). Hospitals should take note; otherwise their accreditation could be at risk.

The Compendium of Strategies to Prevent Health Care-Associated Infections in Acute Care Hospitals was produced by SHEA and IDSA in partnership with the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), and The Joint Commission, and is endorsed by an additional 29 health care organizations.

There are already more than 1200 recommendations on HAI prevention, said SHEA President P.J. Brennan, MD. What has been missing is clear, practical guidance on how to implement the best, evidence-based strategies. “Too often where we fail is not in knowledge, but in execution,” he said. The compendium attempts to address that shortfall.

“Not all HAIs are preventable, but it is imperative that we implement practices that we know are effective to prevent as many of these infections as possible,” said SHEA spokeswoman Deborah S. Yokoe, MD, lead author of the strategies.

“We looked at all existing HAI guidelines and literature to create recommendations that are understandable, easy-to-use, and stress accountability,” said David Classen, MD, IDSA spokesman and co-author of the strategies. Unlike other recommendations, the compendium outlines not only what hospitals should be doing but also what they should not do—because the science doesn’t support it.

The compendium follows an easy-to-use, outline format with checklists, advice on who should be responsible for what specific tasks, and details about the infrastructure that’s needed to accomplish the various strategies. Measures are included so that hospitals can chart their progress. “If you don’t measure it, you don’t improve,” said Dr. Classen.

The Joint Commission has incorporated the compendium’s recommendations into its 2009 National Patient Safety Goals. Starting this year, all hospitals will have to review their current practices and risks, and decide which of the compendium strategies they need to implement. In 2010, the recommendations will be added to The Joint Commission’s accreditation standards.

“As of today, the nation’s infection control team has a common playbook,” said Rich Umbdenstock, president and CEO of AHA at a press conference announcing the compendium.

 Recommendations are prioritized into two categories:

  1. Minimum basic practices that should be adopted by all acute care hospitals—such as removing catheters as soon as they are no longer necessary
  2. Special approaches for use in locations or populations within hospitals when infections are not controlled using basic practices. The evidence for using these approaches isn’t as strong as it is for the basic practices, or the benefit is seen mostly in outbreak settings—such as chlorhexidine baths or universal MRSA screening.

Two sections focus on preventing spread of specific organisms:

Four sections focus on device-and procedure-associated HAIs:

The compendium will be published as a supplement to SHEA’s journal Infection Control and Healthcare Epidemiology.

Accompanying the compendium are user-friendly patient guides that were authored by SHEA and endorsed by the Centers for Disease Control and Prevention, IDSA, and the other partners. The compendium, patient guides, and related materials are available online at
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