Tessa Quinn
The CDC (Centers for Disease Control and Prevention) provides guidelines for hospitals to prevent the spread of infections and manage infectious diseases. These guidelines cover various aspects, including hand hygiene, masking, isolation procedures, and respiratory protection. While hospitals generally follow CDC guidelines, the specific regulations they adhere to can vary based on their location and the prevailing health conditions. The CDC also offers recommendations for specific viruses, such as SARS-CoV-2 and COVID-19, to help hospitals manage these infections effectively. The CDC's guidance is subject to updates as new scientific knowledge becomes available, and hospitals adjust their practices accordingly.
| Characteristics | Values |
|---|---|
| CDC's role | "Conducts critical science and provides health information" to protect the nation |
| CDC's infection control guidelines | Describe specific clinical practices to reduce HAIs |
| Infection control standards | Active prevention, control, and investigation of infections |
| Infection control policies | Educating hospital personnel, sterile processing, hand hygiene, disinfecting surfaces |
| CDC's communication | Social media channels, newsletters, health alerts |
| CDC's guidance | Essential employees can continue working after Coronavirus exposure |
| CDC's role in emergencies | Access to health care, access to primary care, health insurance coverage, and health literacy |
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What You'll Learn
Hospitals must educate staff about infection control
Hospitals are responsible for educating their staff about infection control. This is a fundamental component of a hospital's infection control program. Healthcare workers can reduce the risk of healthcare-acquired infections and protect themselves, patients, and visitors by following CDC guidelines. The CDC provides information on infection control and clinical safety to help reduce the risk of infections among healthcare workers, patients, and visitors.
Healthcare professionals need to be educated and periodically reinforce their knowledge through seminars and workshops to ensure a high understanding of how to prevent communicable disease transmission. Hospitals might develop infection prevention programs that include surveillance, isolation, outbreak management, environmental hygiene, employee health, education, and infection prevention policies and management.
Simple standard precautions such as hand hygiene can be highly effective. Hospitals should promote and enable handwashing by providing reminders at all bedsides and sinks or hand sanitizer stations available at the entrance to each room. Another simple measure is to educate patients to try to use their forearm to block their cough or sneeze to avoid the transmission of droplets and the direct contamination of their hands, which can then transfer pathogens to other surfaces.
Infection control standards that CMS, the Joint Commission, and AOA require as part of the hospital certification and accreditation processes vary in number and content among the organizations. However, they generally describe the fundamental components of a hospital infection control program, including the active prevention, control, and investigation of infections. Examples of standards that hospitals must follow include educating hospital personnel about infection control and having infection control policies in place.
CDC healthcare infection control guidelines include recommendations such as the education and training of healthcare professionals on infection prevention, injection, and medication safety. The CDC's core infection prevention practice domains are intended to serve as a standard reference and reduce the need to repeatedly evaluate practices that are considered basic and accepted standards of medical care.
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Hospitals must have infection control policies
The World Health Organization (WHO) has introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, which are associated with higher mortality rates and increased healthcare costs. Healthcare workers play a critical role in implementing IPC measures, which have become standard and include hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance. Hospitals can also implement modern air filtration systems to reduce the risk of spreading infections through the air.
Infection control committees within hospitals are responsible for generating, implementing, and maintaining policies related to infection control. These committees consist of an interprofessional group of clinicians, nurses, administrators, epidemiologists, infection preventionists, and other representatives from various hospital departments. Hospitals can also develop infection prevention liaison programs by appointing a healthcare professional to disseminate infection prevention information to all hospital members.
To achieve a successful infection control program, hospitals must address important topics related to employee well-being and infection prevention. This includes managing exposure to bloodborne communicable diseases and ensuring that employees are up-to-date with their vaccinations and have adequate immunity against common communicable infections. Continuous training on infection prevention techniques and compliance feedback are also necessary to ensure effective monitoring and adherence to infection control procedures.
Additionally, hospital epidemiologists play a crucial role in ensuring that all infection control policies are up-to-date and based on the latest evidence-based literature. They need to monitor newly emerging multidrug-resistant pathogens and consider the balance between cost, clinical outcomes, patient satisfaction, and economic impact when implementing new interventions. Overall, hospitals must prioritize infection control policies and adapt them according to the latest recommendations and advancements to ensure patient safety and prevent the spread of infections.
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Hospitals must report data to NHSN
The National Healthcare Safety Network (NHSN) is a secure, internet-based surveillance system that integrates patient and healthcare personnel safety surveillance systems. It is managed by the Centers for Disease Control and Prevention Division of Healthcare Quality Promotion (CDC, DHQP). All American healthcare facilities are eligible for enrollment in NHSN, including acute-care hospitals, long-term acute care hospitals, psychiatric hospitals, rehabilitation hospitals, and outpatient dialysis centres.
NHSN is the nation's most widely used healthcare-associated infection (HAI) tracking system. It provides facilities, states, regions, and the nation with data needed to identify problem areas, measure progress of prevention efforts, and ultimately eliminate HAIs. NHSN allows healthcare facilities to track antibiotic-resistant (AR) organisms, antibiotic use, and other adverse events (e.g. blood safety).
In addition, NHSN fulfils the Centres for Medicare and Medicaid Services (CMS) and state requirements for HAI-AR reporting, and CMS nursing home COVID-19 reporting requirements. CMS also uses NHSN data and publishes it on its Hospital Compare and Nursing Home Compare websites.
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Hospitals must follow terminal cleaning procedures
Terminal cleaning is particularly important in operating rooms, where the risk of infection is higher due to the nature of surgical procedures. Operating rooms require environmental cleaning at three distinct intervals: before the first procedure, between procedures, and after the last procedure (i.e., terminal cleaning). The surgery department clinical staff usually manages environmental cleaning, and operating room nurses and their assistants sometimes perform cleaning duties along with, or instead of, general cleaning staff.
The first step in terminal cleaning is for staff to suit up in barrier garments, including face masks, gloves, and booties, to prevent the spread of microorganisms outside the contaminated room. All detachable objects and items must be removed from the room for disinfection in controlled environments. This includes disposable personal care items, patient care equipment, soiled linens, and window treatments.
After removing items for disinfection, the cleaning process focuses on surfaces and equipment. All low- and high-touch surfaces must be cleaned and disinfected, including mattresses, bed frames, headboards, and privacy curtains. The CDC recommends proceeding from cleaner to dirtier areas to avoid spreading dirt and microorganisms. For example, during terminal cleaning, clean low-touch surfaces before high-touch surfaces, and clean patient areas before patient toilets.
In addition to following specific cleaning procedures, hospitals must also provide ongoing training for their cleaning staff. Staff should be knowledgeable about the latest cleaning techniques and safety protocols to ensure compliance with guidelines. Regular audits and inspections are conducted to maintain high standards of cleanliness. By adhering to terminal cleaning procedures and providing proper training, hospitals can play a critical role in reducing the risk of infections and ensuring the well-being of patients and healthcare workers.
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Hospitals must provide safe post-operative care
All hospitals must follow the CDC's infection control guidelines, which include specific clinical practices to reduce HAIs (Health-Care-Associated Infections). These guidelines describe the fundamental components of a hospital's infection control program, such as active prevention, control, and investigation of infections. For example, hospitals must educate their staff about infection control and implement policies to prevent the spread of infections.
Post-operative care, or the care received after a surgical procedure, is an essential part of ensuring patient safety and reducing the risk of complications. This care begins immediately after surgery and can last for the duration of the patient's hospital stay and even beyond discharge. The type of post-operative care provided depends on the type of surgery and the patient's health history. It often includes pain management and wound care, with healthcare providers teaching patients about potential side effects and complications.
Before discharge, patients must demonstrate their ability to breathe normally, drink, and urinate. They are advised not to drive immediately after surgery, especially if anesthesia was administered. Patients may experience grogginess, nausea, and fever in the first 24 hours post-surgery, and should follow their doctor's instructions regarding medication, rest, and physical activity.
To ensure safe post-operative care, hospitals must adhere to CDC guidelines for infection control, particularly in preventing and managing HAIs. This includes educating patients and hospital personnel about infection control practices and implementing policies to actively prevent, control, and investigate infections. By following these guidelines, hospitals can reduce the risk of HAIs and improve patient safety during the critical post-operative period.
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Frequently asked questions
Yes, hospitals are expected to follow CDC guidelines. However, the Trump administration terminated the Healthcare Infection Control Practices Advisory Committee (HICPAC) that crafted national standards for hand-washing, mask-wearing, and isolating sick patients.
The termination of the HICPAC means that its guidelines will be frozen in time and unable to evolve with new scientific research. This could potentially put patients, nurses, and healthcare workers at risk.
The CDC's updated guidance for health care workers returning to work during a facility staffing crisis does not apply to immunocompromised healthcare workers. They should follow conventional isolation and return-to-work guidance.
The CDC offers a continuum of options, including contingency and crisis capacity strategies, which facilities can implement sequentially or choose to be more conservative in their approach.
The CDC specifies that symptomatic healthcare workers should return to work only after being fever-free without medication for at least 24 hours and when symptoms have improved.
