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New guidelines to prevent catheter-related infections

Categories: BSIs, CLABSI, Healthcare-associated infections, HICPAC

Naomi O’Grady, MD

Naomi O’Grady, MD

Guest Author – Naomi O’Grady, MD
National Institutes of Health
Medical Director, Clinical Center’s Vascular Access and Conscious Sedation Services.

Recently, hospital-acquired infections have become an important benchmark of hospital quality and patient safety. Many hospitals are now being required to report patient safety data, and some of this data includes infection rates.

I am proud to announce the release of the updated Guideline to Prevent Intravascular Catheter Related Infections. Clinicians and infection control personnel now have the most recent published information on how to best eliminate these types of infections.

Media Reports about Drug-Resistant Infections

Categories: Antimicrobial Resistance, Gram negatives, Healthcare-associated infections, HICPAC, Long Term Care (LTC)

Arjun Srinivasan, MD

Arjun Srinivasan, MD

Author – Arjun Srinivasan, MD
CDC’s Division of Healthcare Quality Promotion

You probably have seen the media reports this week about drug-resistant infections in California healthcare facilities, specifically those in Los Angeles County. What we know, however, is that carbapenem-resistant Klebsiella pneumoniae (CRKP) actually exists in at least 36 states. Originally identified in 1999, CRKP may be present in the other 14 states as well, just not yet reported to CDC. 

CRKP is a Gram-negative bacteria and part of a family called Enterobacteriaceae. Carbapenem-resistant Enterobacteriaceae (or CRE) are able to fight off our last-resort antibiotics and have become an important public health issue resulting in high mortality (death) in patients. 

How can we stop these bugs?  CDC released prevention guidelines on multi-drug resistant organisms in 2006 and guidelines specifically targeting CRE in 2009. [See my previous blog posts on how to prevent CRE.] 

Implementation Science + the Infection Preventionist = Safe Healthcare

Categories: BSIs, CLABSI, Healthcare-associated infections, HICPAC

Russell N. Olmsted, MPH, CIC

Russell N. Olmsted, MPH, CIC

Author – Russ Olmsted, MPH, CIC
2011 APIC President

Infection preventionists (IPs) are subject matter experts on the prevention of healthcare-associated infections (HAIs). IPs track the scientific literature related to HAI prevention, and then watch that evidence as it is distilled into recommendations by CDC’s Healthcare Infection Control Practices Advisory Committee.

But what is being done to ensure that these best-practices are being implemented at the patient bedside?

It is the role of the “effector” [the IP] to take these recommendations and apply them to his/her healthcare organization, in collaboration with direct care co-workers. APIC’s Research Task Force recently reviewed the role of the IP in translating scientific evidence to improve patient safety and effectiveness of care—also known as “implementation science.” This should sound familiar to IPs, as we are typically the “linchpins” of applying research that appears in scientific, peer-reviewed journals to policies and practices implemented by our colleagues at the patient’s bedside.

HICPAC’s Impact – Reflections on Key Decisions and Future Direction

Categories: Healthcare-associated infections, HICPAC, NHSN

PJ Brennan, M.D.

PJ Brennan, M.D.

PJ Brennan, M.D.
Chief Medical Officer
Division of Infectious Diseases, University of Pennsylvania Health System
Chair of the Healthcare Infection Control Practices Advisory Committee (HICPAC)

At my first meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) in October of 2003, the Committee heard reports on guidelines in development for Sterilization and Disinfection and Isolation Precautions. Both of those important documents had been years in development by 2003 and were still years away from public release. HICPAC’s challenges in bringing those documents to conclusion and release led to the adoption of a more efficient and rigorous evidence evaluation process. Our new methods now posted on the HICPAC homepage have been the result of new thinking, new resources and significant investments and will serve HICPAC and its constituencies well for years to come.

As the Committee worked to finish the Sterilization and the Isolation Precautions guidelines a movement was already afoot that would radically alter our landscape. At my second HICPAC meeting in March 2004, I made an oral presentation on the public reporting of healthcare associated infections (HAIs). Two states, Illinois and Pennsylvania, had recently passed laws requiring the disclosure of HAI data. Outside of those states there was little awareness among professionals that as far as the public reporting of HAIs was concerned the train was leaving the station. By the summer of 2004, two more states had mandates and HICPAC was hard at work on a guidance document. Six years later nearly half the hospitals in the United States are participants by mandate in the CDC’s National Healthcare Safety Network – more than a seven fold expansion in its base. It has become the de facto national public reporting system. The early apprehensions and occasional acrimony that characterized the discussion of this issue have largely been replaced with the realization that all stakeholders – patients, hospitals, doctors and nurses and payors have benefitted from the attention and effort. I am proud of the role that DHQP and HICPAC played in fostering better methods of surveillance and reporting of HAIs and in the leadership it displayed in the early months of this national movement.

HICPAC – Taking the Lead on Safe Healthcare Practices

Categories: CAUTI, Healthcare-associated infections, HICPAC

Jeffrey Hageman, MHS

Jeffrey Hageman, MHS

Jeffrey C. Hageman, M.H.S.
CDC Epidemiologist and Executive Secretary of HICPAC
CDC’s Division of Healthcare Quality Promotion

Each morning when I review news headlines about the latest medical research identifying a new cure or danger, questions pop into my head. Was the research study designed correctly? Was the information collected accurately? Does this new research finding mean the older recommendations don’t need to be followed? Fortunately, there are groups of experts who review the evidence, ask these questions, and develop recommendations so that clinicians have the best information available to practice safe care.

One important group that advises the Centers for Disease Control and Prevention (CDC) and the Secretary of Health and Human Services (HHS) is the Healthcare Infection Control Practices Advisory Committee (HICPAC). HICPAC is a federal advisory committee composed of 14 external infection control experts who come from a variety of medical fields such as infectious diseases, nursing, surgery, critical care medicine, and public health. HICPAC also has a consumer advocate representative, as well as representation from both other federal agencies and professional organizations. HICPAC’s primary function is to issue recommendations in the form of guidelines for the prevention of healthcare-associated infections. Guideline topics range from how to prevent catheter-associated urinary tract infections (CAUTIs) and surgical site infections (SSIs) to how personnel should clean medical equipment and rooms between patients.

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