SHEA Guidelines and Expert Guidance Documents

SHEA Expert Guidance Documents and White Papers are developed by a panel of experts who perform a comprehensive review of the available evidence and use their experience and expertise on the topic to make recommendation that assist practitioners. Since there is often not enough published evidence, these documents do not include a formal grading of the evidence. Our formal process for guidance is reviewed regularly and conflicts of interest are established as part of the formal document. If there is a topic you see missing, please email info@shea-online.org with recommendations for the committee.

  • Raising Standards While Watching the Bottom Line: Making a Business Case for Infection Control
    Current - Institutional Policy
    Author:
    SHEA
    Published:
    September 30, 2007
    Abstract:

    The SHEA Board of Directors appointed a task force to draft this evidence‐based guideline to assist hospital epidemiologists in justifying and expanding their programs. Part 1 describes the basic steps needed to complete a business‐case analysis for an individual institution. A case study based on a representative infection control intervention is provided. Part 2 reviews important basic economic concepts and describes approaches that can be used to assess the financial impact of infection prevention, surveillance, and control interventions, as well as the attributable costs of specific healthcare‐associated infections. Both parts of the guideline aim to provide the hospital epidemiologist, infection control professional, administrator, and researcher with the tools necessary to complete a thorough business‐case analysis and to undertake an outcome study of a nosocomial infection or an infection control intervention.

    Authors: Eli N. Perencevich, Patricia W. Stone, Sharon B. Wright, Yehuda Carmeli, David N. Fisman, and Sara E. Cosgrove

  • Revised SHEA Position Paper: Influenza Vaccination of Healthcare Personnel
    Current - Institutional Policy
    Author:
    SHEA
    Published:
    September 1, 2010
    Abstract:

    In large part, the discussion about the rationale for influenza vaccination of healthcare personnel, the strategies designed to improve influenza vaccination rates in this population, and the recommendations made in the 2005 paper still stand. This position paper notes new evidence released since publication of the 2005 paper and strengthens SHEA’s position on the importance of influenza vaccination of HCP. This document does not discuss vaccine allocation during times of vaccine shortage, because the 2005 SHEA Position Paper still serves as the society’s official statement on that issue. SHEA views influenza vaccination of HCP as a core patient and HCP safety practice with which noncompliance should not be tolerated. Therefore, for the safety of both patients and HCP, SHEA endorses a policy in which annual influenza vaccination is a condition of both initial and continued HCP employment and/or professional privileges.

    Authors: Thomas R. Talbot, Hilary Babcock, Arthur L. Caplan, Deborah Cotton, Lisa L. Maragakis, Gregory A. Poland, Edward J. Septimus, Michael L. Tapper and, David J. Weber

  • Guidance for Infection Prevention and Healthcare Epidemiology Programs: Healthcare Epidemiologist Skills and Competencies
    Current - Epidemiology, Fundamentals, Guidelines, Institutional Policy, Quality Improvement
    Author:
    SHEA
    Published:
    January 20, 2015
    Abstract:

    Since its inception in the 1960s, the specialty of infection prevention and control has grown considerably. The field took shape in the 1970s following the landmark Study on the Efficacy of Nosocomial Infection Control (SENIC) project and grew in importance with the emergence of employee safety and multidrug-resistant organisms in the 1980s.1,2 In the 1990s and into the 2000s, the focus on hospital-acquired infection (HAI) prevention grew, so the field played a larger role in regulatory, patient safety, and quality improvement issues. In the present day, infection control data are frequently available to the public and impact hospital finances and healthcare insurance reimbursements.

    Authors: Keith S. Kaye, Deverick J. Anderson, Evelyn Cook, Susan S. Huang, Jane D. Siegel, Jerry M. Zuckerman, and Thomas R. Talbot

  • Infection Prevention and Control in Residential Facilities
    Current - Guidelines, Handy Hygiene, Immunocompromised Patients, Infection Prevention, Institutional Policy, Patients, Pediatrics
    Author:
    SHEA
    Published:
    October 1, 2013
    Abstract:

    This SHEA guideline is the first infection prevention and control guideline to address preventing transmission of infectious agents in “home away from home” residential settings, of which the Ronald McDonald Houses (RMHs) serve as a prototype. Pediatric patients are frequent guests of the family-centered facilities while receiving or recovering from specialized medical therapy. Examples of high-risk populations served in these facilities include families of patients with cancer, recipients of stem cell or solid organ transplants, surgical and/or very-low-birthweight infants who receive care in neonatal intensive care units (NICUs), those with cystic fibrosis, and women with high-risk pregnancies awaiting.

    Authors: Guzman-Cottrill JA, Ravin KA, Bryant KA, Zerr DM, Kociolek L, Siegel JD

  • Necessary Infrastructure of Infection Prevention and Healthcare Epidemiology Programs
    Current - Epidemiology, Fundamentals, Institutional Policy
    Author:
    SHEA
    Published:
    February 1, 2016
    Abstract:

    The scope of a healthcare institution’s infection prevention and control/healthcare epidemiology program (IPC/HE) should be driven by the size and complexity of the patient population served, that population’s risk for healthcare-associated infection (HAI), and local, state, and national regulatory and accreditation requirements. Essential activities of all IPC/HE programs are reviewed in this white paper.

    Authors: Kristina A. Bryant, Anthony D. Harris, Carolyn V. Gould, Eve Humphreys, Tammy Lundstrom, Denise M. Murphy, Russell Olmsted, Shannon Oriola and Danielle Zerr

    Reviewed: November 2018

  • Healthcare Personnel Attire in Non-Operating-Room Settings
    Current - Guidelines, Infection Prevention, Institutional Policy, Patients, Personal Protective Equipment
    Author:
    SHEA
    Published:
    January 21, 2018
    Abstract:

    This SHEA expert guidance gives general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the article has 3 major components: review and interpretation of the medical literature regarding, review of hospital policies related to HCP attire, and a survey of the SHEA Research Network to assess institutional HCP attire policies and perceptions. Although the optimal choice of HCP attire for inpatient care remains undefined, the document provides recommendations on the use of white coats, neckties, footwear, the bare-below-the-elbows strategy, and laundering.

    Authors: Bearman G, Bryant K, Leekha S, Mayer J, Munoz-Price LS, Murthy R, Palmore T, Rupp ME, White J

    Reviewed: June 2018

  • Animals in Healthcare Facilities
    Current - Guidelines, Infection Prevention, Institutional Policy, Patient Education
    Author:
    SHEA
    Published:
    March 2, 2015
    Abstract:

    This SHEA expert guidance provides general guidance to the medical community regarding the management of animals in healthcare based on analysis of the medical literature regarding risks and evidence for animal-to-human transmission of pathogens in the healthcare setting, along with the potential benefits of animal-assisted activities in healthcare, review of hospital policies related to animals in healthcare, and a SHEA Research Network survey assessing institutional policies. It offers specific guidance for acute care hospitals and ambulatory care facilities to develop or modify policies related to animals based on their role (i.e., animal-assisted activities, service animals, research animals, and personal pet visitation). It is not intended to guide the management of animals in other healthcare facilities such as assisted living, nursing homes, or extended-care facilities.

    Authors: Murthy R, Bearman G, Brown S, Bryant K, Chinn R, Hewlett A, George BG, Goldstein EJC, Holzmann-Pazgal G, Rupp ME, Wiemken T, Weese JS, Weber DJ

    Reviewed: April 2019

  • Implementing an Antibiotic Stewardship Program
    Current - Antibiotic Stewardship, Institutional Policy
    Author:
    IDSA & SHEA
    Published:
    April 15, 2016
    Abstract:

    IDSA and SHEA evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care, with recommendations that address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

    Authors: Barlam T, Cosgrove S, Abbo L, MacDougall C, Schuetz A, Septimus E, Srinivasan A, Dellit T, Falck-Ytter Y, Fishman N, Hamilton C, Jenkins T, Lipsett P, Malani P, May L, Moran G, Neuhauser M, Newland J, Ohl C, Samore M, Seo S, Trivedi K

  • Management of healthcare personnel living with hepatitis B, hepatitis C, or HIV in US healthcare institutions
    Current - Bloodbourne Infections, Hepatitis, HIV, Infection Prevention, Institutional Policy, Occupational Health
    Author:
    SHEA, endorsed by IDSA, HIVMA, and SIS
    Published:
    October 14, 2020
    Abstract:

    This SHEA white paper updates the 2010 SHEA guideline, following advances in interventions that reduce risk for occupational exposures and injuries, antiretroviral therapy that can now fully suppress HIV, and evidence of very low risk for transmission from HCP to patients (only 5 occurrences worldwide since 2010). This white paper provides recommendations regarding Category III/exposure-prone procedures. It details factors that contribute to the pathogenesis and transmission risk for HBV, HCV, and HIV, viral load thresholds for any restrictions on HCP practice, categorization of healthcare-associated procedures according to level of risk for bloodborne pathogen transmission, and responsibilities of healthcare organizations, including academic institutions, professional schools, hospitals, and other healthcare facilities.

    Authors: Henderson DK, Dembry L-M, Sifri CD, Palmore TN, Dellinger EP, Yokoe DS, Grady C, Heller T, Weber D, del Rio C, Fishman NO, Deloney VM, Lundstrom T, Babcock HM

  • 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.

  • 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.

  • Disinfection and Sterilization of Prion-Contaminated Medical Instruments
    Current - Guidelines, Infection Prevention, Sterilization and Disinfection
    Author:
    SHEA
    Published:
    February 1, 2010
    Abstract:

    This SHEA guideline provides recommendations for disinfection and sterilization of medical instruments in order to prevent Creutzfeldt‐Jakob disease (CJD), a degenerative neurologic disorder caused by a proteinaceous infectious agent. Prion diseases elicit no immune response, result in a noninflammatory pathologic process confined to the central nervous system, have an incubation period of years, and usually are fatal within 1 year after diagnosis.

    Authors: Rutala WA, Weber DJ

    Reviewed: 2014

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