Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known Coronavirus Disease 2019

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators. Objective Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19). Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations. Conclusions Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence.

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Evidence-Based Design of Healthcare Facilities: Opportunities for Research and Practice in Infection Prevention

Infection Control and Hospital Epidemiology ◽

10.1086/670220 ◽

2013 ◽

Vol 34 (5) ◽

pp. 514-516 ◽

Cited By ~ 17

Author(s):

Craig Zimring ◽

Megan E. Denham ◽

Jesse T. Jacob ◽

David Z. Cowan ◽

Ellen Do ◽

...

Keyword(s):

Infection Prevention ◽

Evidence Based ◽

Healthcare Facilities ◽

Research And Practice

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The implementation of evidence-based infection prevention in healthcare facilities in Egypt: A systematic literature review

Open Access Research Journal of Multidisciplinary Studies ◽

10.53022/oarjms.2021.1.2.0036 ◽

2021 ◽

Vol 1 (2) ◽

pp. 093-099

Author(s):

Nermeen Abdel-Fattah Shehab ◽

Ahmed Atef Faggal ◽

Ashraf Ali Nessim

Keyword(s):

Infection Prevention ◽

Healthcare Providers ◽

Healthcare Facility ◽

Hospital Staff ◽

Evidence Based ◽

Surveillance Systems ◽

Environment Design ◽

Environmental Interventions ◽

Healthcare Facilities ◽

The Impact

The idea of searching: This study tends to assess the impact of implementing evidence-based infection prevention in healthcare facilities in Egypt, with the aim of improving surveillance systems and altering the facility designs according to the data acquired on HAIs patterns. Background: Hospital acquired infections (HAIs) are becoming one of the major concerns for the patients and healthcare providers leading to significant increase in mortality rates, morbidity rates and financial losses for healthcare organizations. The incidence rate of HAI in Egypt was as recorded as 3.7% recently. Certain environmental interventions, implemented during construction of the healthcare facility could lead to enhanced prevention against the transmission and spread of the HAIs. Studies revealed that the integration of Surveillance programs could provide evidence for the designers to alter the healthcare facility design with the aim of infection prevention. Therefore, EBD approach is used to potentially measure psychological and physical effects of the environment design of a health facility on the patients and hospital staff. Methodology: Previous scientific literature is assessed to collect the relevant data which is then organized and analyzed in this study. A systematic review is generated based on the analytical outcomes of the selected data. Conclusion: EBD approach has the potential to prominently decrease HAIs burden in Egyptian healthcare facilities as it provides a diverse insight into the layout, equipment, and materials that contribute in the transmission of pathogens due to faulty design. Findings and recommendations: In order to improve the poor indoor quality by MEP (mechanical, electrical, and plumbing), previous studies have also indicated certain solutions including advancements in private room, improved surface selections, isolation, integration of touchless systems, and enhanced ventilation systems that must be applied in the healthcare facilities in Egypt for infection prevention.

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Immunization among Healthcare Workers in India: A Need or a Want

Journal of Comprehensive Health ◽

10.53553/jch.v09i01.013 ◽

2021 ◽

Vol 9 (1) ◽

pp. 50-51

Author(s):

Raja Danasekaran

Keyword(s):

Infectious Diseases ◽

Healthcare Workers ◽

Infection Prevention ◽

World Health ◽

Healthcare Personnel ◽

Vaccination Programs ◽

Vaccine Preventable Diseases ◽

Control And Prevention ◽

Risk Of Exposure ◽

Health Organization

Immunization is a highly effective way for prevention of some major infectious diseases. Healthcare workers (HCWs) are at greater risk of exposure as well as spread of vaccine preventable diseases, as they are in constant contact with patients and infectious materials. Many of these diseases still carry a potential for resurgence and can lead to outbreaks. Hence, vaccination programs among HCWs form an integral part of infection prevention & control practices, thereby protecting the healthcare personnel from infection and protecting the patients from getting infected. [1] Even in countries with specific vaccination programs for HCWs, the coverage remains very low and the majority are susceptible for vaccine preventable diseases. So, it becomes imperative for a developing country like India and other countries in low-resource settings to have a national vaccination plan for HCWs. [Table 1]. shows the list of vaccines recommended for HCWs by World Health Organization and Center for Disease Control and Prevention. [2,3]

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Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With Coronavirus Disease 2019 (COVID-19)

Clinical Infectious Diseases ◽

10.1093/cid/ciaa478 ◽

2020 ◽

Cited By ~ 115

Author(s):

Adarsh Bhimraj ◽

Rebecca L Morgan ◽

Amy Hirsch Shumaker ◽

Valery Lavergne ◽

Lindsey Baden ◽

...

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Healthcare Professionals ◽

Critical Evaluation ◽

Evidence Based ◽

Efficacy And Safety ◽

Assessment Development ◽

Guideline Panel ◽

Grade Approach ◽

Pharmacologic Therapies

Abstract Background There are many pharmacologic therapies that are being used or considered for treatment of coronavirus disease 2019 (COVID-19). There is a need for frequently updated practice guidelines on their use, based on critical evaluation of rapidly emerging literature. The objective was to develop evidence-based rapid guidelines intended to support patients, clinicians, and other healthcare professionals in their decisions about treatment and management of patients with COVID-19. Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise. Process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 7 treatment recommendations and provided narrative summaries of other treatments undergoing evaluations. Conclusions The panel expressed the overarching goal that patients be recruited into ongoing trials, which would provide much-needed evidence on the efficacy and safety of various therapies for COVID-19, given that we could not make a determination whether the benefits outweigh harms for most treatments.

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Assessment of Infection Prevention and Control Implementation in Primary and Secondary Health Care Facilities in Rivers State

Journal of Community Medicine and Primary Health Care ◽

10.4314/jcmphc.v33i2.7 ◽

2021 ◽

Vol 33 (2) ◽

pp. 100-114

Author(s):

A. Dan-Jumbo ◽

C.T. Briggs-Nduye ◽

T.C. Uzosike

Keyword(s):

Prevention And Control ◽

Infection Prevention ◽

Health Care Facilities ◽

World Health ◽

Healthcare Personnel ◽

Infection Prevention And Control ◽

Cross Sectional ◽

Healthcare Facilities ◽

Rivers State ◽

And Control

Background: Controlling infections in healthcare facilities is necessary for reducing infection transmission. There is limited data on the status of Infection Prevention and Control (IPC) programme in healthcare facilities in Rivers State. An assessment of IPC implementation in health facilities in Rivers State was therefore conducted.Methods: In this cross-sectional study, stratified sampling technique was applied to select 99 healthcare facilities. Health personnel in-charge of selected facilities were interviewed using the validated Infection Prevention and Control Assessment Framework (IPCAF) tool. It was modified to focus on four out of eight core components areas and graded using the World Health Organization IPCAF guidelines.Results: Twenty (20.2%) facilities had IPC programmes with clearly defined objectives and activity plans. A copy of the IPC guidelines was available in 56 (56.6%) facilities, however, only 13 (13.1%) monitored implementation of the guidelines. Forty (40.4%) facilities had healthcare workers that were trained based on updated IPC guidelines. Supply of personal protective equipment was adequate in 29 (29.3%) facilities and a mixed method of healthcare waste disposal was practiced in 46 (46.4%) facilities. Overall, 56 (56.6%) of the facilities had scores within the basic IPC level of practice while 43 (43.4%) had scores within the intermediate level of IPC practice.Conclusion: Findings from this study indicate that IPC committees should be set up in all healthcare facilities with the obligation of updating IPC guidelines, training healthcare personnel, and implementing IPC activities in respective healthcare facilities.

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Evidence calls for practice change in intramuscular injection techniques

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n2p83 ◽

2017 ◽

Vol 8 (2) ◽

pp. 83 ◽

Cited By ~ 3

Author(s):

Pamela K. Strohfus ◽

Oya Paugh ◽

Chelsea Tindell ◽

Paula Molina-Shaver

Keyword(s):

Intramuscular Injection ◽

Evidence Based Practice ◽

Practice Change ◽

Healthcare Personnel ◽

Current Evidence ◽

Evidence Based ◽

Healthcare Facilities ◽

Healthcare Experience ◽

Injection Techniques ◽

Injection Practices

Background and objective: Intramuscular (IM) injections are administered to patients in all health care settings. Even though this procedure is invasive and the evidence supporting the process of administration is extensive, techniques and procedures vary throughout the literature and in practice. The purpose of this descriptive correlational study was to 1) investigate the literature on current evidence-based IM injection procedures pertaining to gender, patient weight, injection site, needle length, and technique, 2) compare surveyed healthcare personnel self-reported IM injection practices, and 3) query respondents on informational resources they access, continuing education they receive, and their years of healthcare experience and higher education.Methods: The Intramuscular Injection Questionnaire (IIQ) was sent via email to various professional healthcare facilities and their respective social media sites. Two hundred and six (206) healthcare personnel of various healthcare backgrounds and educational levels accessed the IIQ via a link to Qualtrics software. SPSS Version 24 was used for data analysis.Results: Most respondents were registered nurses with 4-15+ years of experience. Seventy-eight percent of respondents considered their IM injection knowledge at above average or expert levels. Gender was not considered an important factor when selecting an injection needle among 75% of participants. Of all respondents, 61% use z-track technique, 59% use the ventrogluteal site and 34% always bunch or stretch the skin during injection. IM injection education was not provided in 75% of healthcare facilities.Conclusions: IM injection practices vary among respondents and in the literature; some reported practices are contrary to current evidence-based practice. While the evidence provides some sound recommendations, some procedures are not well-documented or supported including in nursing texts. Nurses and other healthcare personnel must critically analyze the site, depth, needle, volume, medication, vaccine, and whether to bunch or stretch, according to evidence-based practice. Healthcare facilities should provide IM injection education routinely to ensure safe practices. Future studies (Level 1 and 2) are needed to further demonstrate the best evidence leading to safe and effective IM injections.

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Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

Journal of Infection Prevention ◽

10.1177/17571774211012761 ◽

2021 ◽

pp. 175717742110127

Author(s):

Salma Abbas ◽

Faisal Sultan

Keyword(s):

Personal Protective Equipment ◽

Prevention And Control ◽

Infection Prevention ◽

Hospital Staff ◽

Cross Sectional Study ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Cross Sectional ◽

Healthcare Facilities ◽

And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

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Verification of Healthcare Personnel Immunity as a Strategy for Measles Preparedness

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1093 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s431-s432

Author(s):

Rachael Snyders ◽

Hilary Babcock ◽

Christopher Blank

Keyword(s):

Infectious Diseases ◽

Multidisciplinary Team ◽

The United States ◽

Transmission Risk ◽

Healthcare Personnel ◽

Serological Tests ◽

Preparedness Plan ◽

Vaccine Preventable Diseases ◽

Measles Outbreaks ◽

Centralized Database

Background: Immunization resistance is fueling a resurgence of vaccine-preventable diseases in the United States, where several large measles outbreaks and 1,282 measles cases were reported in 2019. Concern about these measles outbreaks prompted a large healthcare organization to develop a preparedness plan to limit healthcare-associated transmission. Verification of employee rubeola immunity and immunization when necessary was prioritized because of transmission risk to nonimmune employees and role of the healthcare personnel in responding to measles cases. Methods: The organization employs ∼31,000 people in diverse settings. A multidisciplinary team was formed by infection prevention, infectious diseases, occupational health, and nursing departments to develop the preparedness plan. Immunity was monitored using a centralized database. Employees without evidence of immunity were asked to provide proof of vaccination, defined by the CDC as 2 appropriately timed doses of rubeola-containing vaccine, or laboratory confirmation of immunity. Employees were given 30 days to provide documentation or to obtain a titer at the organization’s expense. Staff with negative titers were given 2 weeks to coordinate with the occupational heath department for vaccination. Requests for medical or religious accommodations were evaluated by occupational heath staff, the occupational heath medical director, and the human resources department. All employees were included, though patient-interfacing employees in departments considered higher risk were prioritized. These areas were the emergency, dermatology, infectious diseases, labor and delivery, obstetrics, and pediatrics departments. Results: At the onset of the initiative in June 2019, 4,009 employees lacked evidence of immunity. As of November 2019, evidence of immunity had been obtained for 3,709 employees (92.5%): serological evidence of immunity was obtained for 2,856 (71.2%), vaccine was administered to 584 (14.6%), and evidence of previous vaccination was provided by 269 (6.7%). Evidence of immunity has not been documented for 300 (7.5%). The organization administered 3,626 serological tests and provided 997 vaccines, costing ∼$132,000. Disposition by serological testing is summarized in Table 1. Conclusions: A measles preparedness strategy should include proactive assessment of employees’ immune status. It is possible to expediently assess a large number of employees using a multidisciplinary team with access to a centralized database. Consideration may be given to prioritization of high-risk departments and patient-interfacing roles to manage workload.Funding: NoneDisclosures: None

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Legal Requirements for Infection Prevention and Control Training Among Healthcare Personnel

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.558 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s70-s70

Author(s):

Lauren Weil ◽

Alexa Limeres ◽

Astha KC ◽

Carissa Holmes ◽

Tara Holiday ◽

...

Keyword(s):

Prevention And Control ◽

Infection Prevention ◽

Healthcare Personnel ◽

Infection Prevention And Control ◽

Content Areas ◽

Training Requirements ◽

Training Content ◽

And Control ◽

Dental Professionals

Background: When healthcare providers lack infection prevention and control (IPC) knowledge and skills, patient safety and quality of care can suffer. For this reason, state laws sometimes dictate IPC training; these requirements can be expressed as applying to various categories of healthcare personnel (HCP). We performed a preliminary assessment of the laws requiring IPC training across the United States. Methods: During February–July 2018, we searched WestlawNext, a legal database, for IPC training laws in 51 jurisdictions (50 states and Washington, DC). We used standard legal epidemiology methods, including an iterative search strategy to minimize results that were outside the scope of the coding criteria by reviewing results and refining search terms. A law was defined as a regulation or statute. Laws that include IPC training for healthcare personnel were collected for coding. Laws were coded to reflect applicable HCP categories and specific IPC training content areas. Results: A total of 278 laws requiring IPC training for HCP were identified (range, 1–19 per jurisdiction); 157 (56%) did not specify IPC training content areas. Among the 121 (44%) laws that did specify IPC content, 39 (32%) included training requirements that focused solely on worker protections (eg, sharps injury prevention and bloodborne pathogen protections for the healthcare provider). Among the 51 jurisdictions, dental professionals were the predominant targets: dental hygienists (n = 22; 43%), dentists (n = 20; 39%), and dental assistants (n = 18; 35%). The number of jurisdictions with laws requiring training for other HCP categories included the following: nursing assistants (n = 25; 49%), massage therapists (n = 11; 22%), registered nurses (n = 10; 20%), licensed practical nurses (n = 10; 20%), emergency medical technicians and paramedics (n = 9; 18%), dialysis technicians (n = 8; 18%), home health aides (n = 8;16%), nurse midwives (n = 7; 14%), pharmacy technicians (n = 7; 14%), pharmacists (n = 6; 12%), physician assistants (n = 4; 8%), podiatrists (n = 3; 6%), and physicians (n = 2; 4%). Conclusions: Although all jurisdictions had at least 1 healthcare personnel IPC training requirement, many of the laws lack specificity and some focus only on worker protections, rather than patient safety or quality of care. In addition, the categories of healthcare personnel regulated among jurisdictions varied widely, with dental professionals having the most training requirements. Additional IPC training requirements exist at the facility level, but this information was not analyzed as a part of this project. Further analysis is needed to inform our assessment and identify opportunities for improving IPC training requirements, such as requiring IPC training that more fully addresses patient protections.Funding: NoneDisclosures: None

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Facile syringe filter-enabled bacteria separation, enrichment, and buffer exchange for clinical isolation-free digital detection and characterization of bacterial pathogens in urine

The Analyst ◽

10.1039/d1an00039j ◽

2021 ◽

Author(s):

Pengfei Zhang ◽

Aniruddha Kaushik ◽

Kathleen E Mach ◽

Kuangwen Hsieh ◽

Joseph C. Liao ◽

...

Keyword(s):

Infectious Diseases ◽

Antibiotic Therapy ◽

Broad Spectrum ◽

Antimicrobial Susceptibility ◽

Susceptibility Testing ◽

Evidence Based ◽

Pathogen Identification ◽

Accelerated Methods ◽

Syringe Filter

The development of accelerated methods for pathogen identification (ID) and antimicrobial susceptibility testing (AST) for infectious diseases is necessary to facilitate evidence-based antibiotic therapy and reduce clinical overreliance on broad-spectrum...

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