SHEA Guidelines and Expert Guidance Documents

Observational studies compare outcomes among subjects with and without an exposure of interest, without intervention from study investigators. Observational studies can be designed as a prospective or retrospective cohort study or as a case-control study. In healthcare epidemiology, these observational studies often take advantage of existing healthcare databases, making them more cost-effective than clinical trials and allowing analyses of rare outcomes. This paper addresses the importance of selecting a well-defined study population, highlights key considerations for study design, and offers potential solutions including biostatistical tools that are applicable to observational study designs.

Authors: Graham M. Snyder, Heather Young, Meera Varman, Aaron M. Milstone, Anthony D. Harris, and Silvia Munoz-Price

https://doi.org/10.1017/ice.2016.118

A framework for achieving elimination of HAIs using successful preventive practices and public health strategies to achieve the goal of eliminating HAIs builds upon the basis of lessons from recent successes and require constant action and vigilance. These are: implement evidence-based practices that protect patients; align incentives to promote system-wide strategies for HAI prevention; address gaps in knowledge to push beyond the current medical knowledge; and collect data to target prevention efforts and to measure progress.

Authors: Denise Cardo, Penelope H. Dennehy, Paul Halverson, Neil Fishman, Mel Kohn, Cathryn L. Murphy, Richard J. Whitley, and HAI Elimination White Paper Writing Group

https://doi.org/10.1086/656912

This complete update in Infection Control and Healthcare Epidemiology to the 2008 Compendium. Published in July 2014 with evidence-based, practical recommendations for acute care hospitals for the prevention of common HAIs.

• Synthesizes evidence and expert consensus
• Highlights basic HAI prevention strategies
• Provides special approaches for outbreak management
• Describes implementation strategies and frameworks

Joint policy statement of IDSA, the Society for Healthcare Epidemiology of America (SHEA), and the Pediatric Infectious Diseases Society (PIDS) supporting universal immunization of health care personnel by health care employers as recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC).

IDSA, SHEA, and PIDS Joint Policy Statement on Mandatory Immunization of Health Care Personnel According to the ACIP-Recommended Vaccine Schedule

Antimicrobial resistance has emerged as a significant healthcare quality and patient safety issue in the twenty-first century that, combined with a rapidly dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health of the United States. Antimicrobial stewardship programs optimize antimicrobial use to achieve the best clinical outcomes while minimizing adverse events and limiting selective pressures that drive the emergence of resistance and may also reduce excessive costs attributable to suboptimal antimicrobial use. Therefore, antimicrobial stewardship must be a fiduciary responsibility for all healthcare institutions across the continuum of care. This position statement of the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society of America outlines recommendations for the mandatory implementation of antimicrobial stewardship throughout health care, suggests process and outcome measures to monitor these interventions, and addresses deficiencies in education and research in this field as well as the lack of accurate data on antimicrobial use in the United States.

Authors: Neil Fishman, Society for Healthcare Epidemiology of America, Infectious Diseases Society of America and, Pediatric Infectious Diseases Society

https://doi.org/10.1086/665010

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

https://doi.org/10.1086/521852

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

https://doi.org/10.1086/656558

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

https://doi.org/10.1017/ice.2014.79

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.

https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.15653

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.

https://doi.org/10.1016/j.gie.2020.09.048

This SHEA expert guidance provides a framework to guide practitioners in when to evaluate nursing home residents for infection if they exhibit non-specific signs or symptoms, including fever, hypothermia, low blood pressure, high blood sugar, delirium, behavioral changes, functional decline, falls, and anorexia.

Authors: Rowe TA, Jump RLP, Andersen BM, Banach DB, Bryant KA, Doernberg SB, Loeb M, Morgan DJ, Morris AM, Murthy RK, Nace DA, Crnich CJ

https://doi.org/10.1017/ice.2020.1282