Special Edition on Infection Prevention & Control | Page 28

on activities being performed; minimizing Potential Exposures
(e.g. respiratory hygiene and cough etiquette); and reprocessing
of reusable medical equipment between each patient and
when soiled. Standard Precautions are the basic practices that
apply to all patient care, regardless of the patient’s suspected
or confirmed infectious state, and apply to all settings where
care is delivered. These practices protect healthcare personnel
and prevent healthcare personnel or the environment from
transmitting infections to other patients.
6. Transmission-Based Precautions
● Implement additional precautions (i.e., Contact, Droplet,
and/or Airborne Precautions) for patients with documented or
suspected diagnoses where contact with the patient, their body
fluids, or their environment presents a substantial transmission
risk despite adherence to Standard Precautions.
● Adapt transmission-based precautions to the specific
healthcare setting, the facility design characteristics, and the
type of patient interaction.
● Implement transmission-based precautions based on the
patient’s clinical presentation and likely infection diagnoses
(e.g., syndromes suggestive of transmissible infections such as
diarrhea, meningitis, fever and rash, respiratory infection) as
soon as possible after the patient enters the healthcare facility
(including reception or triage areas in emergency departments,
ambulatory clinics or physicians’ offices) then adjust or discontinue
precautions when more clinical information becomes
available (e.g., confirmatory laboratory results).
● To the extent possible, place patients who may need
transmission-based precautions into a single-patient room
while awaiting clinical assessment.
● Notify accepting facilities and the transporting agency
about suspected infections and the need for transmission-based
precautions when patients are transferred.
● Implementation of Transmission-Based Precautions may
differ depending on the patient care settings (e.g., inpatient,
outpatient, long-term care), the facility design characteristics,
and the type of patient interaction, and should be adapted to
the specific healthcare setting.
7. Temporary invasive Medical Devices for Clinical
Management
● During each healthcare encounter, assess the medical
necessity of any invasive medical device (e.g., vascular catheter,
indwelling urinary catheter, feeding tubes, ventilator, surgical
drain) to identify the earliest opportunity for safe removal.
● Ensure that healthcare personnel adhere to recommended
insertion and maintenance practices.
● Early and prompt removal of invasive devices should be
part of the plan of care and included in regular assessment.
Healthcare personnel should be knowledgeable regarding risks
of the device and infection prevention interventions associated
with the individual device and should advocate for the patient
by working toward removal of the device as soon as possible.
8. Occupational Health
● Ensure that healthcare personnel either receive immunizations
or have documented evidence of immunity against
vaccine-preventable diseases as recommended by the CDC,
CDC’s Advisory Committee on Immunization Practices (ACIP)
and required by federal, state or local authorities.
● Implement processes and sick leave
policies to encourage healthcare personnel
to stay home when they develop signs
or symptoms of acute infectious illness
(e.g. fever, cough, diarrhea, vomiting,
or draining skin lesions) to prevent
spreading their infections to patients and
other healthcare personnel.
● Implement a system for healthcare
personnel to report signs, symptoms, and
diagnosed illnesses that may represent
a risk to their patients and coworkers to
their supervisor or healthcare facility staff
who are responsible for occupational
health.
● Adhere to federal and state
standards and directives applicable to
protecting healthcare workers against
transmission of infectious agents
including OSHA’s Bloodborne Pathogens
Standard, Personal Protective Equipment
Standard, Respiratory Protection standard
and TB compliance directive.
● It is the professional responsibility
of all healthcare organizations and individual
personnel to ensure adherence
to federal, state and local requirements
concerning immunizations; work policies that support safety of
healthcare personnel; timely reporting of illness by employees
to employers when that illness may represent a risk to patients
and other healthcare personnel; and notification to public health
authorities when the illness has public health implications or
is required to be reported.
STRIVE Program
The STRIVE
curriculum was
developed by
national infection
prevention experts
led by the Health
Research &
Educational Trust
(HRET), which
recruited
462 hospitals
in 28 states
and the District
of Columbia, with
443 hospitals
completing the
12-month
program.
One of the most comprehensive sources of information for
infection prevention programs is contained in a repository of
resources known as the STRIVE (States Targeting Reduction
in Infections via Engagement) program, which uses the HAI
National Action Plan goals from the Centers for Disease Control
and Prevention (CDC). STRIVE, which was conducted from
2015 to 2018, focused on improving infection control practices
and strengthening key stakeholder relationships to improve
infection control efforts at the hospital and statewide levels.
The STRIVE curriculum was developed by national infection
prevention experts led by the Health Research & Educational
Trust (HRET), which recruited 462 hospitals in 28 states and
the District of Columbia, with 443 hospitals completing the
12-month program. STRIVE used evidence-based HAI reduction
strategies and relationship-based methods to address infection
rates in hospitals with a high cumulative attributable difference
rate in Clostridioides difficile and at least one other HAI (central
line-associated bloodstream infection, catheter-associated
urinary tract infection, or methicillin-resistant Staphylococcus
aureus infection).
As Bhatt and Collier (2019) explain, “The curriculum emphasized
horizontal (called ‘foundational’) infection prevention
strategies, such as hand hygiene and environmental cleaning,
that cut across all HAIs, as well as socio-adaptive solutions,
such as team-building and leadership engagement, to address
28 IP&C Special Edition June 2020 • www.healthcarehygienemagazine.com