Executive Summary

Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services (2019)

This document, Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services, is an update of four sections of Part I of the Guideline for infection control in health care personnel, 1998 (“1998 Guideline“) and their corresponding recommendations in Part II:

• C. Infection Control Objectives for a Personnel Health Service
• D. Elements of a Personnel Health Service for Infection Control
• H. Emergency-Response Personnel
• J. The Americans With Disabilities Act

Those sections described the infrastructure and routine practices of Occupational Health Services (OHS) for providing occupational infection prevention and control (IPC) services to healthcare personnel (HCP), as well as special considerations associated with emergency response personnel and provisions in the Americans with Disabilities Act (ADA) that are relevant to OHS.

The updated recommendations in this document are aimed at the leaders and staff of OHS and the administrators and leaders of healthcare organizations (HCO) and are intended to facilitate the provision of occupational IPC services to HCP. The recommendations address eight IPC elements of OHS:

1. Leadership and management
2. Communication and collaboration
3. Assessment and reduction of risks for infection among HCP populations
4. Medical evaluations
5. Occupational IPC education and training
6. Immunization programs
7. Management of potentially infectious exposures and illnesses
8. Management of HCP health records

In this document, “OHS” is used synonymously with “Employee Health,” “Employee Health Services,” “Employee Health and Safety,” “Occupational Health,” and other such programs. OHS refers to the group, department, or program that addresses many aspects of health and safety in the workplace for HCP, including the provision of clinical services for work-related injuries, exposures, and illnesses. In healthcare settings, OHS addresses workplace hazards including communicable diseases; slips, trips, and falls; patient handling injuries; chemical exposures; HCP burnout; and workplace violence.

The term “HCP” refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances; contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. For this document, HCP does not include dental healthcare personnel, autopsy personnel, and clinical laboratory personnel, as recommendations to address occupational IPC for these personnel are available elsewhere.

The term “healthcare settings” refers to places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, and others.

The infrastructure and delivery of healthcare to patients, and hence the provision of occupational IPC services to HCP, has changed since the publication of the 1998 Guideline. The recommendations in this document update the 1998 Guideline recommendations with:

• a broader range of elements necessary for providing occupational IPC services to HCP;
• applicability to the wider range of healthcare settings where patient care is now delivered, including hospital-based, long-term care, and outpatient settings such as ambulatory and home healthcare; and
• expanded guidance on policies and procedures for occupational IPC services and strategies for delivering occupational IPC services to HCP.

New topics include:

• administrative support and resource allocation for OHS by senior leaders and management,
• service oversight by OHS leadership, and
• use of performance measures to track occupational IPC services and guide quality improvement initiatives.

The recommendations are informed by a systematic literature review of recent articles consistent with current approaches in occupational IPC service delivery to HCP published in peer-reviewed journals or repositories of systematic reviews from January 2004-December 2015 and a review of occupational IPC guidelines, regulations, and standards. The recommendations are classified as good practice statements based upon the expert opinions of the authors and the Healthcare Infection Control Practices Advisory Committee (HICPAC).