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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.

  • Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship—Observational Studies
    Current - Antimicrobial Stewardship, Guidelines, Knowledge & Skills, Research
    Author:
    SHEA
    Published:
    June 20, 2016
    Abstract:

    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

  • Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals
    Current - Clinical Practice
    Author:
    SHEA, IDSA, AHA, APIC, The Joint Commission
    Published:
    May 10, 2016
    Abstract:

    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
  • Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update
    Current - Clinical Practice, Guidelines, Immunocompromised Patients, Infection Prevention
    Author:
    Cystic Fibrosis Foundation, SHEA
    Published:
    May 10, 2016
    Abstract:

    This CFF and SHEA guideline updates the 2003 Cystic Fibrosis Foundation recommendations for infection prevention and control to reduce the risk of acquisition and transmission of pathogens among people with CF.

    Authors: Saiman L, Siegel JD, LiPuma JJ, Brown RF, Bryson EA, Chambers MJ, Downer VS, Fliege J, Hazle LA, Jain M, Marshall BC, O’Malley C, Pattee SR, Potter-Bynoe G, Reid S, Robinson KA, Sabadosa KA, Schmidt HJ, Tullis E, Webber J, Weber DJ

    Reviewed: 8/1/2014

  • Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Randomized Controlled Trials
    Current - Antimicrobial Stewardship, Guidelines, Knowledge & Skills, Research
    Author:
    SHEA
    Published:
    April 25, 2016
    Abstract:

    Randomized controlled trials (RCT) produce the strongest level of clinical evidence when comparing interventions. RCTs are technically difficult, costly, and require specific considerations including the use of patient- and cluster-level randomization and outcome selection. In this methods paper, we focus on key considerations for RCT methods in healthcare epidemiology and antimicrobial stewardship (HE&AS) research, including the need for cluster randomization, conduct at multiple sites, behavior modification interventions, and difficulty with identifying appropriate outcomes. We review key RCTs in HE&AS with a focus on advantages and disadvantages of methods used. A checklist is provided to aid in the development of RCTs in HE&AS.

    Authors: Deverick J. Anderson, Manisha Juthani-Mehta, and Daniel J. Morgan

  • 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

  • Necessary Infrastructure of Infection Prevention and Healthcare Epidemiology Programs
    Under Review - 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

  • Isolation Precautions for Visitors
    Current - Guidelines
    Author:
    SHEA
    Published:
    April 10, 2015
    Abstract:

    This manuscript was created to provide general recommendations for isolation precautions among visitors based on the literature and a survey of the Society for Healthcare Epidemiology of America (SHEA) membership and SHEA Research Network (SRN). For endemic situations with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), we recommend not using contact isolation precautions, although visitors interacting with multiple patients should use isolation practices similar to those of HCWs. Utilization of contact precautions should be considered for visitors to patients with extensively drug-resistant Gram-negative organisms (eg, Klebsiella pneumoniae carbapenemase (KPC) or enteric pathogens with diarrhea, such as Clostridium difficile and norovirus). Visitors with extensive documented exposure to the symptomatic patient prior to hospitalization such as parents/guardians/family members may be excluded from isolation precautions. These recommendations should be adapted to patient populations and individual hospital needs.

  • 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

  • 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

  • Guidance for the Knowledge and Skills Required for Antimicrobial Stewardship Leaders
    Current - Antimicrobial Stewardship, Guidelines, Knowledge & Skills
    Author:
    SHEA
    Published:
    December 1, 2014
    Abstract:

    Antimicrobial stewardship (AS) refers to coordinated interventions to improve and measure the appropriate use of antimicrobials by promoting the selection of the optimal antimicrobial drug regimen, dose, duration of therapy and route of administration. The objectives of antimicrobial stewardship are to achieve the best clinical outcomes related to antimicrobial use while minimizing emergence of antimicrobial resistant organisms, Clostridium difficile infection, and other adverse events and reducing excessive costs attributable to suboptimal antimicrobial use.

    Authors: Sara E. Cosgrove, Elizabeth D. Hermsen, Michael J. Rybak, Thomas M. File, Sarah K. Parker, and Tamar F. Barlam

  • Policy Statement on Mandatory Immunization of Health Care Personnel
    Current - Institutional Policy
    Author:
    SHEA, IDSA, PIDS
    Abstract:

    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).

  • Infection Prevention and Control in Residential Facilities
    Current - Guidelines, Hand 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

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