SHEA Guidelines and Expert Guidance Documents

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

https://doi.org/10.1086/678592

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

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

https://doi.org/10.1086/673141

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

Under Review

https://doi.org/10.2146/ajhp120568

Misuse and overuse of antimicrobials, primarily involving therapeutic agents used to treat infection in humans, is considered one of the world’s most pressing public health problems. Not only does such inappropriate use diminish the therapeutic benefit of essential medications, it also facilitates the development and spread of multidrug-resistant organisms (MDROs). Antimicrobial resistance and the rise in MDROs globally are associated with increased morbidity and mortality, cross-transmission within and between healthcare settings, and increased consumption of limited patient-care resources. Despite elevated awareness, publication of guidelines on antimicrobial stewardship, and several initiatives, the proportion of resistant strains causing both health care- and community-associated infections continues to increase and the number of new antimicrobials continues to decline.

Authors: Julia Moody, Sara E. Cosgrove, Russell Olmsted, Edward Septimus, Kathy Aureden, Shannon Oriola, Gita Wasan Patel and, Kavita K. Trivedi

https://doi.org/10.1086/665037

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

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

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

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

https://doi.org/10.1086/650197

This SHEA/APIC guideline provides recommendations for prevention and control of infections in long-term care facilities, including UTIs, respiratory tract infections, skin and soft-tissue infections and infestations, gastrointestinal infections, infections caused by antibiotic-resistant organisms, and epidemic infections. It also reviews the structure and elements of infection control programs in the long-term care setting, regulatory considerations, education, and surveillance.

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

https://doi.org/10.1086/592416

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