Compendium 2022 Update: Strategies for Healthcare-associated Infection Prevention

Updated recommendations on how to prevent central line-associated bloodstream infections (CLABSIs), as well as ventilator-associated pneumonia, ventilator-associated events (VAEs), and non-ventilator healthcare-associated pneumonia (NV-HAP) were recently published. These changes come at a time when the need to strengthen infection prevention programs and help hospitals rebuild and support healthcare systems is urgent. These two guidance documents are the first of seven that will be released throughout 2022 as a part of the updates to the infection prevention resource: SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals. The Compendium, as it is commonly known, provides practical recommendations for preventing healthcare associated infections (HAIs) that have major impacts on the quality and safety of patient care.

First published in 2008 and updated in 2014, the third release of this nationally and globally utilized resource continues to provide up-to-date, concise, and practical recommendations for essential infection prevention practices and guidance on how to build them into the delivery of care.

After two decades of declining HAI rates, the COVID-19 pandemic made it extremely difficult for healthcare systems to maintain their HAI prevention efforts. These challenges lead to extensive increases in some HAIs despite the extraordinary dedication and tireless efforts of infection prevention specialists, healthcare epidemiologists, and antimicrobial stewards.^1,2

The 2022 update has a new article dedicated to the use of implementation strategies to put HAI prevention recommendations into practice. These articles also include implementation guidance for the prevention of specific HAIs. These resources pair well with CDC guidelines and help make infection prevention efforts better. The Compendium is the product of a partnership among several organizations focused on infection prevention and quality improvement. It is led by the Society for Healthcare Epidemiology of America (SHEA) and developed with the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of organizations and societies, including the Centers for Disease Control and Prevention (CDC), the Pediatric Infectious Disease Society (PIDS), and the Surgical Infection Society (SIS).

Compendium recommendations are developed from scientific research findings, evaluations, expert consensus, as well as practical and implementation-based considerations. It divides recommendations into “essential practices” that should be adopted by all acute care hospitals, and “additional approaches” that can be considered for use the essential practices are not as effective as needed.

The Compendium can be used to expand and reinforce multidisciplinary and organizational efforts to build stronger HAI prevention infrastructures that address system weaknesses (like those highlighted during the COVID-19 pandemic) and are evidence-based, sustainable, and resilient. Epidemics, pandemics, and other disruptions in healthcare delivery will continue to exist in the future and patients will count on our delivery of safe, high-quality, and high-value care. The Compendium: 2022 updates will be an essential resource to strengthen HAI prevention programs and build better, safer healthcare systems.

1. Weiner-Lastinger LM, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2022; 43:12-25.
2. Fleisher LA, et al. Health care safety during the pandemic and beyond—building a system that ensures resilience. New Engl J of Med 2022; 386:609-611

Lisa Maragakis, M.D., M.P.H., FSHEA, FIDSA is a professor of medicine and epidemiology at Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health. Dr. Maragakis is the Senior Director of Infection Prevention, for The Johns Hopkins Health System and the Hospital Epidemiologist for The Johns Hopkins Hospital. In these roles, she is responsible for the conceptualization, planning, implementation, and development of the Johns Hopkins Health System’s infection control and prevention program. Her research interests are the epidemiology, prevention and control of healthcare-acquired infections and antimicrobial-resistant gram-negative bacilli. Dr. Maragakis serves as the Executive Director of the Johns Hopkins Hospital Biocontainment Unit and as Incident Commander for the Johns Hopkins Medicine COVID-19 response.  She also serves as the IDSA Co-Chair for the Update of the Compendium of Strategies to Prevent Healthcare-Associated Infections, and as Co-Chair of the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC).

Dr. Deborah Yokoe is a Professor of Clinical Medicine in the Division of Infectious Diseases, Department of Medicine at University of California, San Francisco. She is the Medical Director for Hospital Epidemiology and Infection Prevention for the adult services and an attending physician on the Transplant Infectious Diseases consultation service.  She has served as the co-chair of the U.S. Department of Health and Human Services’ Healthcare Infection Control Practices Advisory Committee (HICPAC) which advises the Centers for Disease Control and Prevention on infection prevention and control issues and serves as the SHEA Co-Chair for the Update of the Compendium of Strategies to Prevent Healthcare-Associated Infections. She is also a member of the Society for Healthcare Epidemiology of America (SHEA) Board of Trustees, currently serving as SHEA President-Elect.