SHEA Guidelines and Expert Guidance Documents

SHEA Expert Guidance Documents, Expert Consensus Statements, Guidelines, and White Papers are developed by panels of experts who review the available evidence, and apply their clinical experience and expertise to make practical recommendations. The process for development of the first three types of documents is described in the Handbook for SHEA-Sponsored Expert Guidance, Consensus, and Guideline Documents (pdf). The Handbook does not define the development process for white papers. The Handbook is reviewed and updated periodically by the SHEA Guidelines Committee, and updates are approved by the Board of Trustees.

  • Improving antimicrobial use through better diagnosis: The relationship between diagnostic stewardship and antimicrobial stewardship
    Current - Diagnostic Stewardship
    Author:
    SHEA
    Published:
    September 4, 2023
    Abstract:

    This publication is part of a series whose purpose is to provide an overview of diagnostic stewardship. Here, we discuss the distinct and complementary relationship between diagnostic and antimicrobial stewardship and demonstrate how diagnostic stewardship interventions may complement ASPs.

  • Strategies to prevent Clostridioides difficile infections in acute-care hospitals: 2022 Update
    Current - C. difficile, Compendium, Infection Prevention
    Author:
    SHEA/IDSA/APIC/AHA/The Joint Commission/CDC
    Published:
    April 12, 2023
    Abstract:

    Previously published guidelines provided comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals to implement and prioritize their Clostridioides difficile infection (CDI) prevention efforts. This document updates the Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission.

  • Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force
    Current - Diagnostic Stewardship
    Author:
    SHEA
    Published:
    February 14, 2023
    Abstract:

    We provide an overview of diagnostic stewardship with key concepts that include the diagnostic pathway and the multiple points where interventions can be implemented, strategies for interventions, the importance of multidisciplinary collaboration, and key microbiologic diagnostic tests that should be considered for diagnostic stewardship. The document focuses on microbiologic laboratory testing for adult and pediatric patients and is intended for a target audience of healthcare workers involved in diagnostic stewardship interventions and all workers affected by any step of the diagnostic pathway (i.e., ordering, collecting, processing, reporting, and interpreting results of a diagnostic test).

  • SHEA statement on antibiotic stewardship in hospitals during public health emergencies
    Current - Antibiotic Stewardship, Outbreak Response, Public Health, SHEA White Paper
    Author:
    SHEA
    Published:
    September 14, 2022
    Abstract:

    Authors: Tamar F. Barlam, Mayar Al Mohajer, Jaffar A. Al-Tawfiq, Antonie J. Auguste, Cheston B. Cunha, Graeme N. Forrest, Alan E. Gross, Rachael A. Lee, Susan K. Seo, Kathryn N. Suh, Stacy Volk
    and Joshua K. Schaffzin

  • Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update
    Current - Compendium, Healthcare-associated Infections, Infection Prevention, Ventilator-Associated Pneumonia
    Author:
    SHEA/IDSA/APIC
    Published:
    May 20, 2022
    Abstract:

    The purpose of this document is to highlight practical recommendations to assist acute care hospitals to prioritize and implement strategies to prevent ventilator-associated pneumonia (VAP), ventilator-associated events (VAE), and non-ventilator hospital-acquired pneumonia (NV-HAP) in adults, children, and neonates. This document updates the Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA), and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

  • Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update
    Current - CLABSI, Compendium, Healthcare-associated Infections, Infection Prevention
    Author:
    SHEA, IDSA & APIC
    Published:
    April 19, 2022
    Abstract:

    Previously published guidelines provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing their central line-associated bloodstream infection (CLABSI) prevention efforts. This document updates the Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute-Care Hospitals published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

  • SHEA NICU White Paper Series: Practical approaches for the prevention of central line-associated bloodstream infections
    Current - CLABSI, Clinical Practice, Guidelines, Immunocompromised Patients, Infection Prevention, NICU, NICU White Paper Series, Pediatrics
    Author:
    SHEA
    Published:
    March 4, 2022
    Abstract:

    This document is part of the “SHEA neonatal intensive care unit (NICU) white paper series.” It is intended to provide practical, expert opinion, and/or evidence-based answers to frequently asked questions about CLABSI detection and prevention in the NICU. This document serves as a companion to the CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) Guideline for Prevention of Infections in Neonatal Intensive Care Unit Patients. Central line-associated bloodstream infections (CLABSIs) are among the most frequent invasive infections among infants in the NICU and contribute to substantial morbidity and mortality. Infants who survive CLABSIs have prolonged hospitalization resulting in increased healthcare costs and suffer greater comorbidities including worse neurodevelopmental and growth outcomes. A bundled approach to central line care practices in the NICU has reduced CLABSI rates, but challenges remain. This document was authored by pediatric infectious diseases specialists, neonatologists, advanced practice nurse practitioners, infection preventionists, members of the HICPAC guideline-writing panel, and members of the SHEA Pediatric Leadership Council. For the selected topic areas, the authors provide practical approaches in question-and-answer format, with answers based on consensus expert opinion within the context of the literature search conducted for the companion HICPAC document and supplemented by other published information retrieved by the authors. Two documents in the series precede this one: “Practical approaches to Clostridioides difficile prevention” published in August 2018 and “Practical approaches to Staphylococcus aureus prevention,” published in September 2020.

    Authors: Martha Muller, Kristina A. Bryant, Claudia Espinosa, Jill A. Jones, Caroline Quach, Jessica R. Rindels, Dan L. Stewart, Kenneth M. Zangwill, and Pablo J. Sánchez

  • NICU White Paper Series: Respiratory Infections
    Under Development - Clinical Practice
  • Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel
    Current - Consensus Statement
    Author:
    SHEA, AMDA, APIC, HIVMA, IDSA, PIDS, SIDP
    Published:
    July 13, 2021
    Abstract:

    This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).

  • Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults
    Current - Focused Update, Guidelines
    Author:
    IDSA and SHEA
    Published:
    June 14, 2021
    Abstract:

    This clinical practice guideline is a focused update on management of Clostridioides difficile infection (CDI) in adults specifically addressing the use of fidaxomicin and bezlotoxumab for the treatment of CDI. This guideline was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). This guideline is intended for use by healthcare professionals who care for adults with CDI, including specialists in infectious diseases, gastroenterologists, hospitalists, pharmacists, and any clinicians and healthcare providers caring for these patients. The panel’s recommendations for the management CDI are based upon evidence derived from topic-specific systematic literature reviews. Summarized below are the recommendations for the management of CDI in adults. The panel followed a systematic process which included a standardized methodology for rating the certainty of the evidence and strength of recommendation using the GRADE approach (Grading of Recommendations Assessment, Development, and Evaluation). A detailed description of background, methods, evidence summary and rationale that support each recommendation, and knowledge gaps can be found online in the full text.

  • Disinfection of Ultrasound Transducers Use for Percutaneous Procedures
    Current - Clinical Practice, Guidelines, Infection Prevention, Sterilization and Disinfection
    Author:
    ACEP, with AIUM, SHEA, APIC, AVA
    Published:
    February 1, 2021
    Abstract:

    This intersociety position statement addresses the issue of disinfection of transcutaneous ultrasound transducers used for percutaneous procedures or for monitoring other invasive procedures. Some organizations are not congruent in their recommendations for disinfection, with recommendations for high-level disinfection of sheathed probes for percutaneous procedures being not evidence-based and resulting in unwarranted and unnecessary use of resources, increase the possibility of safety events if procedures are performed without ultrasound guidance. This statement addresses several specific points for determining when to use high-level disinfection appropriately.

  • Multisociety guideline on reprocessing flexible GI endoscopes and accessories
    Current - Clinical Practice, Guidelines, Infection Prevention, Sterilization and Disinfection
    Author:
    Written by ASGE, endorsed by SHEA, AASLD, AGA, AORN, APIC, ASCA, ASCRS, SGNA
    Published:
    January 5, 2021
    Abstract:

    This ASGE-led multisociety guideline updates the 2016 version, to address gaps and variation in implementing infection prevention practices are common in endoscopy units across the United States. Given the rising concerns of endoscope-related infections, this guideline evaluates the current literature and standards for endoscope reprocessing and expands details related to the critical reprocessing steps of cleaning and drying and incorporates recent evidence as it pertains to improving the reprocessing of GI endoscopes.

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