Top CDC Recommendations to Prevent Healthcare-Associated Infections
Health and Human Services Secretary Kathleen Sebelius announced an initiative, the Partnership for Patients: Better Care, Lower Costs, aimed at protecting patients in America’s healthcare facilities through the prevention of healthcare-acquired conditions. Medical advances have brought lifesaving care to patients in need, yet many of these advances come with a risk of a healthcare-acquired conditions, including infections.
CDC’s top recommendations to prevent infections [PDF - 381 KB] are below:
To Prevent Catheter-Associated Urinary Tract Infections (CAUTIs:)
- Insert catheters only for appropriate indications
- Leave catheters in place only as long as needed
- Ensure that only properly trained persons insert and maintain catheters
- Insert catheters using aseptic technique and sterile equipment (acute care setting)
- Follow aseptic insertion, maintain a closed drainage system
- Maintain unobstructed urine flow
- Comply with CDC hand hygiene recommendations and Standard Precautions
Also consider:
- Alternatives to indwelling urinary catheterization
- Use of portable ultrasound devices for assessing urine volume to reduce unnecessary catheterizations
- Use of antimicrobial/antiseptic-impregnated catheters
For the full CAUTI prevention toolkit, visit the Prevention Tools page
Full CDC guidelines available at HICPAC website
To Prevent Surgical Site Infections (SSIs):
Before surgery
- Administer antimicrobial prophylaxis in accordance with evidence-based standards and guidelines
- Treat remote infections-whenever possible before elective operations
- Avoid hair removal at the operative site unless it will interfere with the operation; do not use razors
- Use appropriate antiseptic agent and technique for skin preparation
During Surgery
- Keep OR doors closed during surgery except as needed for passage of equipment, personnel, and the patient
After Surgery
- Maintain immediate postoperative normothermia
- Protect primary closure incisions with sterile dressing
- Control blood glucose level during the immediate post-operative period (cardiac)
- Discontinue antibiotics according to evidence-based standards and guidelines
Also consider
Before surgery:
- Nasal screening and decolonization for Staphylococcus aureus carriers for select procedures (i.e., cardiac, orthopaedic, neurosurgery procedures with implants).
- Screen preoperative blood glucose levels and maintain tight glucose control
During surgery:
- Redose antibiotic at the 3 hr interval in procedures with duration >3hrs
- Adjust antimicrobial prophylaxis dose for obese patients (body mass index >30)
- Use at least 50% fraction of inspired oxygen intraoperatively and immediately postoperatively in select procedure(s)
For the full SSI prevention toolkit, visit the Prevention Tools page
Full CDC guidelines available at HICPAC website
To Prevent Central Line-Associated Bloodstream Infections (CLABSIs) Outside ICUs:
- Remove unnecessary central lines
- Follow proper insertion practices
- Facilitate proper insertion practices
- Comply with CDC hand hygiene recommendations
- Use appropriate agent for skin antisepsis
- Choose proper central line insertion sites
- Perform adequate hub/access port disinfection
- Provide staff education on central line maintenance and insertion
Also consider:
- Chlorhexidine bathing
- Antimicrobial-impregnated catheters
- Chlorhexidine-impregnated dressings
For the full CLABSI prevention toolkit, visit the Prevention Tools page
Full CDC guidelines available at HICPAC website
To Prevent Clostridium difficile Infections (CDI)
- Contact Precautions for duration of diarrhea
- Comply with CDC hand hygiene recommendations
- Adequate cleaning and disinfection of equipment and environment
- Laboratory-based alert system for immediate notification of positive test results
- Educate about C. diff infection: healthcare personnel, housekeeping, administration, patients, families
Also consider:
- Extend use of Contact Precautions beyond duration of diarrhea (e.g., 48 hours)
- Presumptive isolation for symptomatic patients pending confirmation of C. diff infection
- Evaluate and optimize testing for C. diff infection
- Implement soap and water for hand hygiene before exiting room of a patient with C. diff infection
- Implement universal glove use on units with high C. diff infection rates
- Use EPA-registered disinfectants with sporicidal claim (e.g., bleach) or sterilants for environmental disinfection
- Implement an antimicrobial stewardship program
For the full C. difficile prevention toolkit, visit the Prevention Tools page
Full CDC guidelines available at HICPAC website
To Prevent MRSA Infections
- Comply with CDC hand hygiene recommendations
- Implement Contact Precautions for MRSA colonized and infected patients
- Recognize previously MRSA colonized and infected patients
- Rapidly report MRSA lab results
- Provide MRSA education for healthcare providers
Also consider:
- Active surveillance testing – screening of patients to detect colonization even if no evidence of infection
- Other novel strategies
- Decolonization
- Chlorhexidine bathing
For the full CAUTI prevention toolkit, visit the Prevention Tools page
Full CDC guidelines available at HICPAC website
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