Prevent
Infection
|
Step 1. Vaccinate
-Give influenza/pneumococcal vaccine to at-risk patients
before discharge
-Get influenza vaccine annually
Step 2. Get the Catheters out
-Use catheters only when essential
-Use the correct catheter
-Use proper insertion and catheter-care protocols
-Remove
catheters when they are no longer essential |
Step 1. Vaccinate Staff
and Patients
Get influenza vaccine
Give influenza and pneumococcal vaccine
to patients in addition to routine vaccines (e.g. hepatitis B)
Step 2. Get the Catheters
out
Hemodialysis
Use catheters only when essential
Maximize use of fistulas/grafts
Remove catheters when they are no longer
essential
Peritoneal Dialysis
Remove/replace
infected catheters
Step 3. Optimize Access Care
Follow established KDOQI and CDC Guidelines
for access care
Use proper insertion and catheter-care
protocols
Remove access device when infected
Use the correct catheter |
Step 1. Prevent surgical
site infections
-Monitor and maintain
normal glycemia
-Maintain normothermia
-Perform proper skin preparation using appropriate antiseptic agent and, when
necessary, hair removal techniques
-Think outside the wound to stop surgical site infections
Step 2. Prevent device-related
infections: get the devices out
-Use
catheters only when essential
-Use proper insertion and catheter-care protocols
-Use drains appropriately
-Remove
catheters and drains when they are no longer essential
Step 3. Prevent hospital-acquired pneumonia
- Wean from the ventilator when appropriate
- Elevate head of bed to 30°
- Drain circuit/tubing
condensate away from patient
- Prevent contamination of respiratory therapy equipment, ventilator circuits and respiratory
medications.
|
Step 1. Vaccinate hospitalized
children and staff
- Vaccinate according
to AAP/ACIP/AAFP recommendations
- Catch-up with routine vaccinations prior to discharge from the hospital
- Give influenza
vaccine to at-risk infants and children
- Get influenza vaccine
Step 2. Get the devices out
- Insert catheters and devices only when essential and minimize duration of exposure
- Use the correct catheter
-
Use proper insertion and catheter-care protocols
- Remove catheters and other devices when no longer essential |
Step 1. Vaccinate
- Give influenza and pneumococcal vaccinations to residents
-
Promote vaccination among all staff
Step 2. Prevent conditions
that lead to infection
- Prevent aspiration
-
Prevent pressure ulcers
- Maintain hydration
Step 3. Get the unnecessary devices out
- Insert catheters and devices only when essential and minimize duration of exposure
- Use proper insertion
and catheter-care protocols
- Reassess catheters regularly
- Remove catheters and other devices when no longer essential |
|
Diagnose
&
Treat
Infection
Effectively |
Step
3. Target the pathogen
-Culture
the patient
-Target empiric therapy to likely pathogens and local antibiogram
-Target definitive therapy to known pathogens
and antimicrobial susceptibility test results
Step 4. Access the experts
-Consult infectious diseases experts for patients with serious infections |
Step
4. Target the Pathogen
Obtain
appropriate cultures
Target empiric therapy to likely pathogens
Target definitive
therapy to known pathogens
Optimize timing, regimen, dose, route, and duration
Step 5. Access the Experts
Consult
the appropriate expert for complicated infections |
Step 4. Target the pathogen
- Target empiric antimicrobial therapy to likely pathogens
- Obtain appropriate
cultures
- Target definitive antimicrobial therapy to known pathogens
- Optimize timing, regimen, dose, route, and duration
of antimicrobial therapy
- Practice safe source control (e.g. debridement, or open wound as indicated)
Step 5. Access the experts
- Consult the appropriate expert for complicated infections:
surgeons; infectious disease
experts; clinical pharmacists |
Step
3. Use appropriate methods for diagnosis
- Order appropriate lab tests
- Obtain appropriate specimens
Step
4. Target the pathogen
-
Target empiric antimicrobial therapy to likely pathogens
- Target definitive antimicrobial therapy to known pathogens
Step 5. Access the experts
- Consult infectious disease experts for complicated infections |
Step
4. Use established criteria for diagnosis of infection
- Target empiric therapy to likely pathogens
- Target definitive therapy to
known pathogens
- Obtain appropriate cultures and interpret results with care
- Consider C. difficile in patients
with diarrhea and antibiotic exposure
Step 5. Use local resources
- Consult infectious disease experts for complicated infections and potential
outbreaks
- Know your local and/or regional data
- Get previous microbiology data for transfer residents
|
|
Use
Antimicrobials
Wisely |
Step 5. Practice antimicrobial control
-Engage in local antimicrobial control efforts.
Step 6. Use local data
-Know your antibiogram.
-Know your patient population.
Step 7. Treat infection, not contamination
-Use proper antisepsis for blood and other cultures.
-Culture
the blood, not the skin or catheter hub.
-Use proper methods to obtain and process all cultures.
Step 8.
Treat infection, not colonization
-Treat pneumonia, not the tracheal aspirate.
-Treat bacteremia, not the catheter tip
or hub.
-Treat urinary tract infection, not the indwelling catheter.
Step 9. Know when to say "no" to vanco
-Treat infection, not contaminants or colonization.
-Fever in
a patient with an intravenous catheter is not a routine indication for vancomycin.
Step 10. Stop antimicrobial treatment:
-When infection
is cured.
-When cultures are negative and infection is unlikely
-When infection is not diagnosed.
|
Step 6. Use local data
Know
your local antibiogram
Get previous microbiology results when patients transfer to your facility
Step 7. Know when to say "no" to vanco
Follow CDC guidelines for vancomycin use
Consider 1st generation
cephalosporins instead of vancomycin
Step 8.
Treat infection, not contamination or colonization
Use proper antisepsis for drawing blood cultures
Get one peripheral
vein blood culture, if possible
Avoid culturing vascular catheter tips
Treat bacteremia, not the catheter tip
Step 9. Stop Antimicrobial Treatment
When
infection is treated
When infection is not diagnosed |
Step 6. Start prophylactic antimicrobials promptly
- Give the initial dose within one hour preceding
incision
- Use the appropriate antimicrobial and dosing
- Repeat the dose during surgery as needed to maintain blood
levels
Step 7. Stop prophylactic antimicrobials within 24 hours
- Discontinue use even with catheters
or drains still in place
Step 8. Use local data
- Know your antibiogram
- Know your formulary
- Know your patient
population
Step 9. Know when to say “no” to vanco
- Vanco should be used to treat known infections,
not for routine prophylaxis
- Treat staphylococcal infection, not contaminants or colonization
- Consider other antimicrobials
in treating MRSA
Step 10. Treat infection, not contamination or colonization
- Use proper
antisepsis for drawing blood cultures
- Get at least one peripheral vein blood culture, if possible
- Avoid culturing
vascular catheter tips
- Treat bacteremia, not the catheter tip |
Step 6. Practice antimicrobial control
- Optimize timing, regimen, dose, route, and duration of antimicrobial
treatment and prophylaxis
- Follow policies and protocols in your institution
Step 7. Use local data
- Know your regional, institutional, and high-risk unit-specific antibiograms
-
Know your formulary
- Know your patient population (birthweight, age, and setting)
Step 8. Treat infection, not contamination or colonization
- Use proper antisepsis for drawing
blood cultures
- Avoid culturing catheter tips
- Treat bacteremia, not catheter colonization or contamination
Step 9. Know when to say “no”
- Avoid routine use of vancomycin, extended-spectrum cephalosporins,
carbapenems, oral quinolones, and linezolid
- Follow guidelines from CDC, AAP, and other professional societies
Step 10. Stop treatment
- When infection is unlikely
-
When culture results indicate no clinical need for antimicrobials
- When infection is cured |
Step 6. Know when to say “no”
- Minimize use of broad-spectrum antibiotics
- Avoid chronic
or long-term antimicrobial prophylaxis
- Develop a system to monitor antibiotic use and provide feedback to appropriate
personnel
Step 7. Treat infection, not colonization or contamination
- Perform proper antisepsis with culture
collection
- Re-evaluate the need for continued therapy after 48-72 hours
- Do not treat asymptomatic bacteriuria
Step 8. Stop antimicrobial treatment
- When cultures are negative and
infection is unlikely
- When infection has resolved |
|
Prevent
transmission |
Step 11. Isolate the pathogen
-Use standard infection control precautions.
-Contain infectious
body fluids. (Follow airborne, droplet, and contact precautions.)
-When in doubt, consult infection control experts.
Step 12. Break the chain of contagion
-Stay
home when you are sick.
-Keep your hands clean.
-Set an example. |
Step 10: Follow Infection Control Precautions
Use standard infection control precautions
for dialysis centers
Consult
local infection control experts
Step 11: Practice Hand Hygiene
Wash your hands or use an alcohol-based
handrub
Set an example
Step 12: Partner With Your Patients
Educate on access care and infection control
measures
Re-educate regularly |
Step 11. Contain your contaminant
and contagion
- Follow infection control
precautions
- Consult infection control teams
12. Practice hand hygiene
- Set
an example
- Wash your hands or use an alcohol-based handrub
- Do not operate with open sores on hands
- Do not
operate with artificial nails
- Promote good habits for the entire surgical team |
Step 11. Practice infection
control
- Consult infection control teams
-
Stay home when you are sick
- Restrict visitors with signs of respiratory or gastrointestinal tract infections from contact
with your patients
Step 12. Practice hand hygiene
-
Wash your hands or use an alcohol-based handrub
- Set an example |
Step 9. Isolate the pathogen
- Use Standard Precautions
- Contain infectious body fluids
(use approved Droplet and Contact isolation precautions)
Step 10. Break the chain of
contagion
- Follow CDC recommendations
for work restrictions and stay home when sick
- Cover your mouth when you cough or sneeze
- Educate staff, residents,
and families
- Promote wellness in staff and residents
Step 11. Perform hand hygiene
- Use alcohol-based handrubs or wash your hands
- Encourage
staff and visitors
Step 12. Identify residents with multi-drug resistant organisms (MDROs)
- Identify both new admissions and existing residents with MDROs
- Follow standard
recommendations for MDRO case management |
