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.

  • Multisociety guidance for infection prevention and control in nursing homes
    Current - Guidelines, Infection Prevention, Institutional Policy, Long-Term Care
    Author:
    SHEA, with representatives from APIC, IDSA, and PALTmed. Endorsed by SHEA, APIC, IDSA, PALTmed, and AGS.
    Published:
    October 20, 2025
    Abstract:

    This multisociety guidance was endorsed by SHEA, APIC, IDSA, PALTmed, and AGS. It provides recommendations for infection prevention and control (IPC) in the context of the increasing complexity of nursing home care in the United States: increased medical acuity of residents, the spread of multidrug-resistant organisms, and the threat of emerging pathogens. Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents’ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining a home-like care space while sustaining necessary IPC measures. The guidance covers the role of regulatory bodies like the Centers for Medicare and Medicaid Services (CMS) and recommendations from the Centers for Disease Control and Prevention (CDC). It should serve as a resource for IPC program leaders in nursing homes who are aiming to enhance infection prevention efforts.

    Authors: Lona Mody, Sonali D. Advani, Muhammad Salman Ashraf, Allison H. Bartlett, Suzanne F. Bradley, Deborah P. Burdsall, Jennifer A. Hanrahan, Susan S. Huang, Robin L.P. Jump, Lindsay Nicolle, Mary-Claire Roghmann, Patricia Stone, Rekha K. Murthy

  • Raising the Bar – Necessary Resources and Structure for Effective Healthcare Facility Infection Prevention and Control Programs
    Current - Guidelines, Infection Prevention, Institutional Policy
    Author:
    SHEA with representatives from APIC, IDSA, PIDS. Endorsed by SHEA, APIC, IDSA, PIDS
    Published:
    April 28, 2025
    Abstract:

    The Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society represent the core expertise regarding healthcare infection prevention and infectious diseases and have written multisociety statement for healthcare facility leaders, regulatory agencies, payors, and patients to strengthen requirements and expectations around facility infection prevention and control (IPC) programs. Based on a systematic literature search and formal consensus process, the authors advocate raising the expectations for facility IPC programs, moving to effective programs that are:

    • Foundational and influential parts of the facility’s operational structure
    • Resourced with the correct expertise and leadership
    • Prioritized to address all potential infectious harms

    This document discusses the IPC program’s leadership—a dyad model that includes both physician and infection preventionist leaders—its reporting structure, expertise, and competencies of its members, and the roles and accountability of partnering groups within the healthcare facility. The document outlines a process for identifying minimum IPC program medical director support. It applies to all types of healthcare settings except post-acute long-term care and focuses on resources for the IPC program. Long-term acute care hospital (LTACH) staffing and antimicrobial stewardship programs will be discussed in subsequent documents.

    Authors: Thomas R. Talbot, Christopher Baliga, Rebecca Crapanzano-Sigafoos, Tania N. Bubb, Mohamad Fakih, Thomas G. Fraser, Ibukunoluwa C. Kalu, Vidya Mony, Anupama Neelakanta, Ann-Christine Nyquist, Catherine O’Neal, Jan E. Patterson, David K. Warren, and Sharon B. Wright

  • Multisociety Guidance for Sterilization and High-level Disinfection
    Current - Guidelines, Hand Hygiene, Infection Prevention, Institutional Policy, Sterilization and Disinfection
    Author:
    SHEA with representatives from: ASGE, APIC, AORN, HSPA, IDSA, SGNA, The Joint Commission. Endorsed by SHEA, APIC, ASGE, SGNA, and IDSA.
    Published:
    April 28, 2025
    Abstract:

    Multisociety infection prevention guidance document for individuals and organizations that engage in sterilization or high-level disinfection (HLD). The guidance provides an overview of the Spaulding Classification and considerations around manufacturers’ instructions for use (MIFUs). Its recommendations address: point-of-use treatment prior to sterilization or HLD, preparation of reusable medical devices at the location of processing, sterilization, and immediate use steam sterilization (IUSS), HLD of lumened and non-lumened devices, processing of reusable medical devices used with lubricating or defoaming agents, monitoring for effectiveness of processing, handling of devices after HLD, augments and alternatives to HLD, processing of investigational devices, tracking of reusable medical devices, and approaches to implementation. This guidance follows the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities and is based on a synthesis of published scientific evidence, theoretical rationale, current practices, practical considerations, writing group consensus, and consideration of potential harm when applicable. The supplementary material includes a summary of recommendations.

    Authors: Shenoy ES, Weber DJ, McMullen K, Rubin Z, Sampathkumar P, Schaffzin JK, Sickbert-Bennett E, Washer L, Yokoe DS, Calderwood AH, Chinn R, Day M, Garcia-Houchins S, Javaid W, Klacik S, Kyle E, Murthy RK, Wood A, Rutala WA

  • Patient, Caregiver, and Visitor Guides for Preventing Infections in the Hospital
    Current
    Author:
    SHEA/IDSA/APIC Compendium Authors and the SHEA Guidelines Committee
    Published:
    January 6, 2025
    Abstract:

    Two guides for patients, caregivers, and visitors. Patient, caregiver, and visitor guides based on the SHEA/IDSA/APIC Compendium and developed with the 2024 SHEA Guidelines Committee.

    The guides provide:
    *Information about hand hygiene, vaccines, and the use of antibiotics
    *Common symptoms and how to recognize and prevent bloodstream infections, urinary tract infections, pneumonia, C. difficile infections, MRSA infections, and surgical site infections
    *Prompts to encourage patients’ and visitors’ participation in preventing infections and staying safe in the hospital.

    Pocket Guide:

    Digital flipbooks (available at no cost):
    *Guide to Being a Safe Patient or Caregiver
    *Guide to Being a Safe Visitor

    Institutional licensing:
    *Access to self-print at your organization or institution
    *Co-branding and other customizations
    *Flat fee based on size and usage
    *Option to integrate into your EHR Contact licensing@guidelinecentral.com or visit GuidelineCentral.com/contact

    Printed versions, available through Guideline Central for individual and bulk orders:
    * Guide to Being a Safe Patient or Caregiver
    * Guide to Being a Safe Visitor

     

  • SHEA practice update: infection prevention and control (IPC) in residential facilities for pediatric patients and their families
    Current - COVID-19, Guidelines, Hand Hygiene, Immunocompromised Patients, Infection Prevention, Institutional Policy, Mpox, Patients, Pediatrics
    Author:
    SHEA, endorsed by PIDS
    Published:
    November 14, 2024
    Abstract:

    Update to the SHEA 2011 infection prevention guidance for pediatric residential facilities that refreshes the literature and recommendations for the topics covered in the 2011 document, as well as guidance for pediatric residential facilities’ staff related to infection prevention of COVID-19, multidrug-resistant organisms including C. auris, Mpox, and updates on standard precautions, respiratory hygiene, safe injection practices, vaccination, screening of visitors, and other IPC topics. The authors revised and expanded on the supportive materials for staff and for visitors, available with the manuscript under “Supplementary Material.”

    Authors: Guzman-Cottrill JA, Blatt DB, Bryant KA, McGrath CL, Zerr DM, Rosenthal A, Kociolek LK, Murphy C, Ravin KA

  • 5 Things Medical Professionals Should Question for Infection Prevention and Antimicrobial Stewardship
    Current - Antimicrobial Stewardship, Infection Prevention
  • 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.

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