2007 Guideline for isolation precautions preventing transmission of infectious agents in healthcare settings
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2007 Guideline for isolation precautions preventing transmission of infectious agents in healthcare settings

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      Guideline for isolation precautions preventing transmission of infectious agents in healthcare settings, 2007
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      2007. Last update: September, 2018 The Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007 updates and expands the 1996 Guideline for Isolation Precautions in Hospitals. The following developments led to revision of the 1996 guideline: 1. The transition of healthcare delivery from primarily acute care hospitals to other healthcare settings (e.g., home care, ambulatorycare, free-standing specialty care sites, long-term care) created a need for recommendations that can be applied in all healthcare settings using commonprinciples of infection control practice, yet can be modified to reflect setting-specific needs. Accordingly, the revised guideline addresses the spectrumof healthcare delivery settings. Furthermore, the term “nosocomial infections” is replaced by “healthcare-associated infections” (HAIs) to reflect thechanging patterns in healthcare delivery and difficulty in determining the geographic site of exposure to an infectious agent and/or acquisition ofinfection. 2. The emergence of new pathogens (e.g., SARS-CoV associated with the severe acute respiratory syndrome [SARS], Avian influenza inhumans), renewed concern for evolving known pathogens (e.g., C. difficile, noroviruses, community-associated MRSA [CA-MRSA]), development of new therapies(e.g., gene therapy), and increasing concern for the threat of bioweapons attacks, established a need to address a broader scope of issues than inprevious isolation guidelines. 3. The successful experience with Standard Precautions, first recommended in the 1996 guideline, has led to a reaffirmation of thisapproach as the foundation for preventing transmission of infectious agents in all healthcare settings. New additions to the recommendations for StandardPrecautions are Respiratory Hygiene/Cough Etiquette and safe injection practices, including the use of a mask when performing certain high-risk, prolongedprocedures involving spinal canal punctures (e.g., myelography, epidural anesthesia). The need for a recommendation for Respiratory Hygiene/CoughEtiquette grew out of observations during the SARS outbreaks where failure to implement simple source control measures with patients, visitors, andhealthcare personnel with respiratory symptoms may have contributed to SARS coronavirus (SARS-CoV) transmission. The recommended practices have a strongevidence base. The continued occurrence of outbreaks of hepatitis B and hepatitis C viruses in ambulatory settings indicated a need to re-iterate safeinjection practice recommendations as part of Standard Precautions. The addition of a mask for certain spinal injections grew from recent evidence of anassociated risk for developing meningitis caused by respiratory flora. 4. The accumulated evidence that environmental controls decrease the risk of life-threatening fungal infections in the most severelyimmunocompromised patients (allogeneic hematopoietic stem-cell transplant patients) led to the update on the components of the Protective Environment(PE). 5. Evidence that organizational characteristics (e.g., nurse staffing levels and composition, establishment of a safety culture)influence healthcare personnel adherence to recommended infection control practices, and therefore are important factors in preventing transmission ofinfectious agents, led to a new emphasis and recommendations for administrative involvement in the development and support of infection controlprograms. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007) 6. Continued increase in the incidence of HAIs caused by multidrug-resistant organisms (MDROs) in all healthcare settings and theexpanded body of knowledge concerning prevention of transmission of MDROs created a need for more specific recommendations for surveillance and control ofthese pathogens that would be practical and effective in various types of healthcare settings. This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, otherhealthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across thecontinuum of care. The reader is referred to other guidelines and websites for more detailed information and for recommendations concerning specializedinfection control problems. This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, otherhealthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across thecontinuum of care. The reader is referred to other guidelines and websites for more detailed information and for recommendations concerning specializedinfection control problems. SiegelJD, Rhinehart E, Jackson M, ChiarelloL, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline forisolation Precautions: Preventing Transmission of Infec tious Agenets in Healthcare Settings, September 2018.
    • Content Notes:
      Jane D. Siegel, Emily Rhinehart, Marguerite Jackson, Linda Chiarello; the Healthcare Infection Control Practices Advisory Committee. September, ‎2018
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