Health Care-Associated Infections

Reporting Health Care-Associated Infections

• Inpatient and outpatient Article 28 facilities (e.g. hospitals and nursing homes) must report suspected and confirmed health care-associated infections to NYSDOH
• Non-Article 28 health care facilities (e.g. adult care facilities and private outpatient medical offices) must report possible suspected and confirmed health care-associated infections to the NYC DOHMH

Reporting Concerns about Infection Control in Medical Facilities

Early reporting of concerns about infection control in medical facilities can help prevent outbreaks of health care-associated infections.

• If you are concerned about unsafe or improper infection control practices at a medical facility, please file a complaint with the New York State Center for Consumer Health Care Information
• To report possible misconduct by a physician, physician assistant, or specialist assistant, contact The Office of Professional Medical Conduct to file a complaint. For other licensed medical professionals, contact The Office of Professional Discipline.

Infection Prevention in Outpatient Settings

• Dedicate staff resources to infection prevention
• Develop written infection control policies and procedures.
• Designate one person in your practice to be responsible for ensuring that written policies are followed.
• Helpful Links:
  • Preventing HAIs in Outpatient Settings (CDC)
  • HHS National Action Plan to Prevent Health Care-Associated Infections: includes sections specific to acute-care hospitals, ambulatory surgical centers, dialysis centers, and long-term care facilities
  • Key Infection Control Practices for Outpatient Health Care Settings (PDF)

Infection Prevention in Long-Term Care Settings

• Best Practices and Good Ideas: A Handbook for Infection Control in Nursing Homes (PDF). A resource for infection preventionists and other nursing home staff to provide a quick review of CDC-recommended best practices for infection control in nursing homes along with implementation resources for infection prevention and control programs. This handbook also includes creative approaches to getting things done that come directly from our nursing home colleagues in NYC.
• The CDC's Long-term Care website provides links to infection control guidance and resources for clinicians, infection prevention coordinators, and residents of long-term care facilities

Hospital-Acquired Infections

Hospital-acquired infections are overseen by the New York State Department of Health (NYSDOH). For more information, please visit the NYSDOH Hospital-Acquired Infection website.

Safe Injection Practices

Safe injection practices prevent the spread of bloodborne pathogens.

• Needles and syringes should be used only once. They should never be used for more than one patient. Never use a previously-used needle or syringe to access a medication vial, and never leave a needle or spike in a medication vial for easy access of syringes.
• Single-dose vials and IV bags are to be used for only one patient. They should never be shared among multiple patients.
• Use single-dose vials whenever possible.
• If multi-dose vials must be used for more than one patient, draw up medication in a clean central location, away from patient care areas.
• Never use a saline bag for multiple patients.
• Helpful Links:
  • Safe Injection Practices Coalition (One and Only Campaign)
  • Your Best Shot: Training Your Staff to Give Safe Injections (PDF)

Safe Glucose Monitoring

• Never share fingerstick devices or insulin pens or reuse lancets.
• Whenever possible, do not share glucometers. Assign each patient a separate glucometer and label it with their name.
  • If a glucometer must be used for multiple patients, clean and disinfect it after every use according to the manufacturer's instructions.
• Helpful Links:
  • Safe Glucometer Use Brochure (PDF)
    Other languages: [En Español]
  • Safe Glucometer Use Poster (PDF)
    Other languages: [En Español]
  • FAQ-Blood Glucose Monitoring
  • Infection Prevention During Glucose Monitoring and Insulin Administration

Safe Food Practices in Health Care Settings

• Hospitals serve food to vulnerable populations at high risk for complications from foodborne illnesses. Outbreaks of listeriosis and other foodborne illness have occurred.
  • For example, pregnant women, the elderly, and patients immunocompromised from chemotherapy are especially at risk for Listeria.
• Infection control practitioners should be aware of the risks of foodborne illness among hospitalized patients and should consider implementing food service policies to minimize patients' exposure to foodborne pathogens.
• Helpful Links:
  • Serving High-Risk Foods in a High-Risk Setting (Survey) - Infection Control and Hospital Epidemiology, 2011
  • Implementation of a Restricted Foods Policy at a Large Academic Medical Center - Infection Control & Hospital Epidemiology, 2014

Publications Describing Health Care-Associated Hepatitis B and C Outbreaks in NYC

• Hepatitis C Transmission Due to Contamination of Multidose Medication Vials - American Journal of Infection Control, 2012
• Investigation of Viral Hepatitis Infections Possibly Associated with Health-Care Delivery - New York City, 2008-2011 - MMWR, 2012
• Multiple Clusters of Hepatitis Virus Infections Associated with Anesthesia for Outpatient Endoscopy Procedures - Gastroenterology, 2010
• A Large Outbreak of Hepatitis B Virus Infections Associated with Frequent Injections at a Physician's Office - Control & Hospital Epidemiology, 2005
• Transmission of Hepatitis B and C Viruses in Outpatient Settings - New York, Oklahoma, and Nebraska, 2000-2002 - MMWR, 2003

Preventing Transmission from Health Care Personnel Infected with Bloodborne Pathogens

• Prevent Transmission of Bloodborne Pathogens from Infected Health Care Personnel Through Medical/Dental Procedures - New York State Department of Health Policy Statement and Guidelines
• Management of Health Care Workers Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus - SHEA Guidelines
• Management of Hepatitis B Virus-Infected Health Care Providers and Students - Updated CDC Recommendations

Publications Describing Non-Hepatitis Health Care-Associated Outbreaks in NYC

• An Outbreak of Klebsiella Pneumoniae and; Enterobacter Aerogenes Bacteremia After Interventional Pain Management Procedures, New York City, 2008 - Regional Anesthesia and Pain Medicine, 2010
• A Cluster of Methicillin-Susceptible Staphylococcus Aureus Infections at a Rheumatology Practice, New York City, 2011 - Infection Control and Hospital Epidemiology, 2014

Resources for Clinicians Affected by Substance Abuse

• Physicians and physician assistants: Medical Society of the State of New York Committee for Physician Health
• Other Health Care Professionals: NYS Education Department Professional Assistance Program
• Nurses: American Nurses Association Impaired Nurse Resource Center