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Healthcare-Associated Infections

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Prevention Approaches that should CLABSI prevention ÎDo ÎDo ÎDo insertion, or while catheters are use antimicrobial prophylaxis for short-term or tunneled catheter (A-I). routinely replace central venous or arterial catheters (A-I). routinely use positive-pressure needleless connectors with mechanical valves before a thorough assessment of risks, benefits, and education regarding proper use (B-II). Prevention of Ventilator-Associated Pneumonia (VAP) Basic practices for prevention and monitoring of VAP* ÎEducate healthcare personnel who care for patients undergoing ventilation about VAP, including information about local epidemiology, risk factors, and patient outcomes (A-II). ÎImplement policies and practices for disinfection, sterilization, and maintenance of respiratory equipment that are aligned with evidence- based standards (eg, guidelines from the Centers for Disease Control and Prevention and professional organizations) (A-II). ÎEducate clinicians who care for patients undergoing ventilation about noninvasive ventilatory strategies (B-III). ÎProvide easy access to noninvasive ventilation equipment and institute protocols to promote the use of noninvasive ventilation (B-III). ÎEnsure that all patients (except those with medical contraindications) are maintained in a semirecumbent position (B-II). ÎPerform regular antiseptic oral care in accordance with product guidelines (A-I). ÎPerform direct observation of compliance with VAP-specific process measures (B-III). ÎConduct active surveillance for VAP and associated process measures in units that care for patients undergoing ventilation who are known or suspected to be at high risk for VAP on the basis of risk assessment (A-II). ÎRegularly provide ICU clinicians and senior hospital leaders with data on VAP and VAP-related process measures (B-III). Special approaches for the prevention of VAP** ÎPerform a VAP risk assessment. ÎUse an endotracheal tube with in-line and subglottic suctioning for all eligible patients (B-II). be considered a routine part of N OT i n si t u N OT N OT N OT

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