Policy Manual sample

MDT Home Health Care Agency, Inc. NOSOCOMIAL INFECTIONS The Centers for Disease Control and Prevention (CDC) has published 2 articles in which nosocomial infection and criteria for specific types of nosocomial infection for surveillance purposes for use in patient care settings, in this document we replace and uses the generic term ‘‘health care–associated infection’’ or ‘‘HAI’’ instead of ‘‘nosocomial.’’ HAIs may be caused by infectious agents from endogenous or exogenous sources. Endogenous sources are body sites, such as the skin, nose, mouth, gastrointestinal (GI) tract, or vagina that are normally inhabited by microorganisms. Exogenous sources are those external to the patient, such as patient care personnel, visitors, patient care equipment, medical devices, or the health care environment. Other important considerations include the following: Clinical evidence may be derived from direct observation of the infection site (eg, a wound) or eview of information in the patient chart or other clinical records. For certain types of infection, a physician or surgeon diagnosis of infection derived from direct observation during a surgical operation, endoscopic examination, or other diagnostic studies or from clinical judgment is an acceptable criterion for an HAI, unless there is compelling evidence to the contrary. For example, one of the criteria for SSI is ‘‘surgeon or attending physician diagnosis.’’ Unless stated explicitly, physician diagnosis alone is not an acceptable criterion for any specific type of HAI. Infections occurring in infants that result frompassage through the birth canal are consideredHAIs. The following infections are not considered health care associated: Infections associated with complications or extensions of infections already present on admission, unless a change in pathogen or symptoms strongly suggests the acquisition of a new infection; Infections in infants that have been acquired transplacentally (eg, herpes simplex, toxoplasmosis, rubella, cytomegalovirus, or syphilis) and become evident #48 hours after birth; and Reactivation of a latent infection (eg, herpes zoster [shingles], herpes simplex, syphilis, or tuberculosis). The following conditions are not infections: Colonization, which means the presence of microorganisms on skin, on mucous membranes, in open wounds, or in excretions or secretions but are not causing adverse clinical signs or symptoms; and Inflammation that results from tissue response to injury or stimulation by noninfectious agents, such as chemicals. CRITERIA FOR SPECIFIC TYPES OF INFECTION Once an infection is deemed to be health care associated according to the definition shown above, the specific type of infection should be determined based on the criteria detailed below. These have been grouped into 13 major type categories to facilitate data analysis. For example, there are 3 specific types of urinary tract infections (symptomatic urinary tract infection, asymptomatic bacteriuria, and other infections of the urinary tract) that are grouped under the major type of Urinary Tract Infection. The specific and major types of infection used in NHSN and their abbreviated codes are listed in Table 1, Home Health Agency Nursing Care & Procedures K-138