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.

  • 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

  • NICU White Paper Series: Practical approaches to S. aureus disease prevention
    Current - C. difficile, CLABSI, Clinical Practice, NICU, NICU White Paper Series, S. aureus
    Author:
    SHEA, endorsed by APIC, IDSA, The Joint Commission, NANN, PIDS, and VON
    Published:
    September 14, 2020
    Abstract:

    These white papers serve as companion to CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients and provide practical, expert opinion and/or evidence-based answers to frequently asked questions on infection detection and prevention in the NICU on S. aureusC. difficile, CLABSI, and respiratory infections.

    Authors: Akinboyo IC, Zangwill KM, Berg WM, Cantey JB, Huizinga B, Milstone AM

  • Evaluation and Management of Penicillin Allergy
    Current - Antibiotic Resistance, Clinical Practice, Infection Prevention
    Author:
    Shenoy ES, Macy E, Rowe T, Blumenthal KG
    Published:
    January 19, 2019
    Abstract:

    β-Lactam antibiotics are among the safest and most effective antibiotics; however, many patients report allergies to these drugs despite few having clinically significant reactions, resulting in the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance and adverse events. This review provides recommendations for the evaluation of penicillin allergies to support antimicrobial stewardship.

  • Infection Prevention in the Operating Room Anesthesia Work Area
    Current - CLABSI, Clinical Practice, Hand Hygiene, Infection Prevention, Surgical Site Infections
    Author:
    SHEA, endorsed by AAAA, AANA, AORN, and ASPF
    Published:
    December 11, 2018
    Abstract:

    This SHEA expert guidance gives infection prevention and control recommendations related to hand hygiene (activities, glove use, alcohol-based hand sanitizer), reusable versus single-use devices, environmental cleaning and management, use of injection ports, barrier precautions, and vials, syringes, and IV bags.

    Authors: Munoz-Price LS, Bowdle A, Johnston BL, Bearman G, Camins BC, Dellinger EP, Geisz-Everson MA, Holzmann-Pazgal G, Murthy R, Pegues D, Prielipp RC, Rubin ZA, Schaffzin J, Yokoe D, Birnbach DJ

  • NICU White Paper Series: Practical approaches to C. difficile prevention
    Current - C. difficile, CLABSI, Clinical Practice, NICU, NICU White Paper Series, S. aureus
    Author:
    SHEA, endorsed by APIC, IDSA, The Joint Commission, NANN, PIDS, and VON
    Published:
    August 30, 2018
    Abstract:

    These white papers serve as companion to CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients and provide practical, expert opinion and/or evidence-based answers to frequently asked questions on infection detection and prevention in the NICU on S. aureusC. difficile, CLABSI, and respiratory infections.

    Authors: Sandora TJ, Bryant KK, Cantey JB, Elward AM, Yokoe DS, Bartlett AH

  • Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update
    Current - Clinical Practice, Guidelines, Immunocompromised Patients, Infection Prevention
    Author:
    Cystic Fibrosis Foundation, SHEA
    Published:
    August 1, 2018
    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

  • Antimicrobial Prophylaxis in Surgery
    Current - Clinical Practice, Guidelines, Infection Prevention, Sterilization and Disinfection, Surgical Site Infections
    Author:
    ASHP, SHEA, IDSA, SIS
    Published:
    March 1, 2018
    Abstract:

    These ASHP, SHEA, IDSA, and SIS clinical practice guidelines provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical-site infections based on available clinical evidence and emerging issues.

    Authors: Bratzler D, Dellinger EP, Olsen K, Perl T, Autwaerter P, Bolon M, Fish D, Napolitano L, Sawyer R, Slain D, Steinberg J, Weinstein R

    Reviewed: 2/4/2013

  • Clinical Practice Guidelines for CDI in Adults and Children: 2017 Update
    Current - Antimicrobial Stewardship, C. difficile, Clinical Practice, Guidelines, Quality Improvement
    Author:
    IDSA and SHEA
    Published:
    February 22, 2018
    Abstract:

    IDSA and SHEA update to the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults, incorporating recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment) and significant changes in the management of CDI reflecting the evolving controversy over best methods for diagnosis. This evidence-based guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.

    Authors: McDonald LC, Gerding D, Johnson S, Bakken J, Carroll K, Coffin S, Dubberke E, Garey K, Gould C, Kelly C, Loo V, Sammons JS, Sandora T, Wilcox M

    Partial Update: January 2021

  • 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

  • Duration of Contact Precautions for Acute-Care Settings
    Current - Clinical Practice, Guidelines, Infection Prevention, Patients, Quality Improvement
    Author:
    SHEA
    Published:
    January 11, 2018
    Abstract:

    This SHEA expert guidance advises hospitals in when they can safely discontinue contact precautions for patients with multidrug-resistant bacteria, addressing how long hospital staff should use these safety protocols to reduce the spread of pathogens within the hospital, in most cases ranging from one to three negative cultures prior to discontinuation. The guidance also outlines the use of molecular testing in care decisions.

    Authors: Banach DB, Bearman G, Barnden M, Hanrahan JA, Leekha S, Morgan DJ, Murthy R, Munoz-Price LS, Sullivan KV, Popovich KJ, Wiemken TL

  • Outbreak Response and Incident Management
    Current - Clinical Practice, Guidelines, Infection Prevention, Outbreak Investigation, Outbreak Response, Public Health
    Author:
    SHEA, cleared by CDC and endorsed by AACN, ACEP, CSTE, HCA Healthcare, IDSA, The Joint Commission, NACCHO, and PIDS
    Published:
    November 30, 2017
    Abstract:

    This SHEA expert guidance document, developed as part of the SHEA/CDC Outbreak Response Training Program (ORTP), provides recommendations for incident management during infectious diseases outbreaks and how to work within an emergency response framework. The guidance’s recommendations are not pathogen-specific and are meant to apply to a range of potential infectious diseases outbreaks.

    Authors: Banach DB, Johnston BL, Al-Zubeidi D, Bartlett AH, Bleasdale SC, Deloney VM, Enfield KB, Guzman-Cottrill JA, Lowe C, Ostrosky-Zeichner L, Popovich KJ, Patel PK, Ravin K, Rowe T, Shenoy ES, Stienecker R, Tosh PK, Trivedi KK

    Pocket Guide:
  • 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

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