Standard Infection Control Precautions Research Articles

Effects of Infection Control Education for Nursing Students Using Standardized Patients vs. Peer Role-Play.

This study was conducted to identify and compare the effects of two education programs for infection control―a simulation using standardized patients and a peer role-play―on standard precaution knowledge, standard precaution awareness, infection-related anxiety, and infection control performance. This study used a nonequivalent control group pretest-posttest design. A total of 62 undergraduate nursing students in their 3rd year participated in the study, and were assigned to the experimental and control groups, accordingly. The infection control education program was developed based on the analysis, design, development, implementation, and evaluation model. The program for the experimental group included lectures, skills training, simulation using standardized patients, and debriefing, while the control group participated in the usual infection control education, consisting of lectures, skills training, and peer tutoring practices. Both groups exhibited statistically significant increases in knowledge, awareness of standard precaution, and infection control performance after the intervention. Infection-related anxiety and infection control performance were significantly higher in the simulation using a standardized patient group. Both education programs influenced compliance with the standard precaution for infection control. The results of this study contribute to the evidence regarding effective educational methods to improve infection control.

Knowledge and Practice of Standard Precautions for Infection Prevention and Control among Health Care Workers in Public Primary and Secondary Health Facilities in Edo State: A Reflection of the Neglect of First and Second Levels of Care in Infection Preve

Standard precautions (SP) refer to the minimum infection prevention practice applied whenever providing patient care, irrespective of the diagnosis. SP is applied to all patients all the time to prevent unprotected contact with body fluids so that bloodborne infections and the risks of infection transmission are unlikely. It involves various components that when consistently practised, prevents the spread of infection to health care workers, patients, and visitors. This study assessed the knowledge and practice of standard precaution among health care workers in public primary and secondary facilities in Edo State. A Cross-Sectional study design was used to study 217 HCWs in both public primary and secondary health facilities. Respondents were selected using the cluster sampling technique. The study was carried out between April and October 2019. Most of the HCWs (94.5%) were aware of SP with their source of awareness, mainly from their colleagues. Their knowledge of SP was generally poor. Only 23 (10.6%) of the respondents had good knowledge, others either had fair 153(70.50%) or poor 41(18.90%) knowledge of SP with a statistically significant relationship between knowledge of SP and the HCWs level of completed education (p-value 0.019) as well as with the professional group they belong to (p-value 0.002). The practice of SP was generally abysmal, with only 3(1%) having good practice. The knowledge and practice of standard precaution among health workers at both the primary and secondary levels of care in Edo State were abysmally poor. There is an urgent need to organise sustained infection prevention and control (IPC) training as well as implement strategies to improve IPC competence among the HCWs in the primary and secondary facilities in Edo State.

Infection Control Practices Among Private Practicing Dentists in Nairobi During the Pre-coronavirus Disease 2019 Period.

Background: Cross-infection control is a dynamic field that requires frequent updates due to emerging diseases, advancement in technology, and scientific knowledge. Despite wide publication of guidelines, a laxity in compliance to the standard precautions for infection control by dental health-care personnel (DHCP) has been reported globally. Therefore, there is need to review previous shortcomings in order to adequately secure dental practices during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to determine knowledge and infection control practices by dentists in private practices. The study was done a few months before the first COVID-19 case was confirmed in Kenya.Materials and Methods: The study design was a descriptive cross-sectional study that was carried out in selected private dental clinics located in Nairobi. Data were collected using an interviewer-administered questionnaire. Convenience sampling method was utilized, while data were analyzed using SPSS 20.0.0.0.Results: A total of 71 private dentists participated in the study. Their mean age was 38 years with an age range of 27–55 years. Almost all (70, 98.6%) the dentists were able to define cross infection correctly. Majority (62, 87.3%) correctly differentiated between sterilization and disinfection, while 9 (12.7%) had difficulties. Most (68, 95.8%) of the respondents were aware of the standard precautions for cross-infection control. All participants used face masks and gloves. About half of them (38, 54%) practiced hand washing after removal of gloves and 31 (43.7%) before and after wearing of gloves, while 2 (2.8%) washed hands only before wearing gloves. Only 31 (42.3%) and 26 (36.6%) participants reported use of rubber dam isolation and impervious barrier, respectively. All the dentists reported disposal of sharps into especially labeled containers, while about half reported use of disposable suction traps and amalgam separators.Conclusion: The dentists had a good knowledge on various aspects of infection control measures that were studied. Use of basic personal protective equipment was widely practiced. There were irregularities in hand hygiene, use of rubber dam, surface barriers, and waste management. The work highlights that many dentists were unprepared to manage infectious risk during the COVID-19 outbreak, which justified the closure of the dental facilities. Development of strategies to promote adequate and safe practice is highly recommended.

중소병원 간호사의 감염예방 표준주의 지침 수행도에 미치는 영향요인

The purpose of this study was to identify the factors that influence the performance to guidelines for the standard precaution of infection prevention for nurses who work in small and medium-sized hospitals. The subjects for this study consisted of 184 nurses from five small and medium-sized hospitals having below 300 beds located in B city. The collected data were analyzed according to frequency, percentage, mean and standard deviation, t-test, one way ANOVA, Scheffé test, Pearson Correlation Coefficient and Multiple regression. The research found that the factors that influence nurses’ Standard precautions were working department(β=-.346 p.001), report after exposure on accident(β=-.229, p=.004), marital status(β=-.216, p.001), knowledge(β=.193, p=.003), and attitude(β=-.144, p=.028). The explained variance for performance was 29.8%(F=10.711, p.001). Based on the findings, it is necessary to improve the safety-climate and continuous educational program, and administrative support should be provide on improve nurses’ performance of standard precautions for healthcare-associated infection control in small- and medium-sized hospitals.

The Urologist, Personal Protective Equipment (PPE) and COVID-19

Background and Objective To review the literature from a urologist’s perspective regarding the use of Personal Protective Equipment (PPE), associated challenges, and other potential measures that can be taken to reduce the risk of nosocomial COVID-19 transmission. Material and Methods A literature review using PubMed, Cochrane Review, and Google Scholar database search was performed using the keyword terms “COVID-19”, “Coronavirus”, “Personal Protective Equipment” (PPE), “healthcare workers” (HCW), “protection”, “masks”, and “urology”. Non-English articles were excluded. We present a summary of key guidance provided by regulatory bodies as well as some of the key articles published to date relating to PPE. Discussion SARS-CoV-2 virus is found mainly in the respiratory system but is also in blood, feces, semen, and urine. Both standard infection control precautions (SICPs) and transmission-based precautions (TBPs) are necessary to reduce nosocomial transmission of COVID-19 infection. PPE includes gowns, gloves, masks or respirators, goggles, and face shields; however, wearing PPE is only part of many precautionary measures that are necessary to prevent viral transmission. When used appropriately PPE not only protects HCWs from patients but also protects patients from HCWs who may be asymptomatic carriers of COVID-19 infection. Attention should also be paid to fit testing and fit checking, donning and doffing, and ever-evolving guidelines on PPE. Wearing PPE for a long time is also technically challenging and may adversely affect surgical outcomes. Shortages of PPE in the supply chain during the peak of the pandemic as well as concerns about substandard PPE should be considered for a possible second wave of COVID-19. Other key measures to minimize nosocomial SARS-CoV-2 virus transmission are a symptom and temperature screening of patients and staff; controlling the flow of patients, staff, and relatives in hospitals; self-isolation by patients before elective surgery; a robust testing protocol for both patients and staff; patient and staff cohorting; physical distancing; good hand hygiene; respiratory etiquette including face coverings for patients, staff and visitors; proper disposal of waste and enhanced cleaning; thorough cleaning and sterilization of surgical equipment performed post-operatively; choosing suitable anesthetic methods to minimize aerosolization of the virus; and if possible ensuring a negative-pressure theatre environment while dealing with COVID-19 positive patients. As scientific and regulatory bodies continue to issue updated guidance as more data is collected and a better knowledge base is developed regarding COVID-19 employers and staff need to keep up to date with guidance also. Conclusion COVID-19 will be around for the foreseeable future and infection rates may fluctuate as restrictions are eased. HCWs including urologists should take appropriate PPE measures not only in theatres, clinics, and endoscopy suits but also when performing simple tasks such as urine dipsticks, catheter, nephrostomy management, digital rectal examination (DRE), prostate biopsies, etc. as SARS-CoV-2 can be detected in feces, urine, and semen. Both employers and HCWs should adhere strictly to current guidelines and work together to minimize nosocomial transmission of COVID-19 infection.

Nasal carriage of Staphylococcus aureus by medical students: Assessment of antibiotic susceptibility and risk factors

Objective: Staphylococcus aureus (S. aureus) is the leading vector for both hospital-sourced and population-sourced infections globally and nasal carriage may be responsible for these serious infections. The aim of this study was to assess the nasal S. aureus carriage rates, antibiotic susceptibility and risk factors among preclinical period medical students.Method: A total of 183 preclinical period students from Ahi Evran University Faculty of Medicine voluntarily participated in our study. They were requested to complete a survey form containing questions about demographic information, hygiene habits and medical history and possible risk factors were recorded. S. aureus isolates proliferating from nasal swab culture samples were studied with antibiotic susceptibility tests.Results: Of the total of 183 students, 39 (21.4%) had S. aureus proliferation identified from nasal swab samples. None of these isolates were methicillin-resistant S. aureus (MRSA). Antibiotic susceptibility tests found highest resistance against penicillin (85%). There were negative correlations between nasal spray use and allergy history with nasal S. aureus carriage.Conclusions: Medical students may each be mobile sources of bacteria in hospitals, especially as MRSA carriers. According to our results, it is necessary to note the importance of training and standard infection control precautions to prevent the increase in MRSA carriage rates in the clinical period as none of our preclinical period students carried MRSA. Advanced studies are important to monitor carriage rates.

Knowledge, Compliance and Determinants of Use of Standard Precautions for Infection Control among Health Care Workers – A Teaching Hospital Based StudyKnowledge, Compliance and Determinants of Use of Standard Precautions for Infection Control among Hea

Introduction: Standard Precautions, which are easily implementable and universally acceptable interventions, can help reduce the transmission of infections in the health care setting. However, knowledge and compliance with regard to Standard Precautions remains unsatisfactory. Materials and Method: This cross sectional study was conducted on 200 health care workers (HCWs) at ESIC Medical College & Hospital, Faridabad. A self-administered structured questionnaire with specific subsections to assess knowledge, attitude and practice of Standard Precautions was used for data collection. Regression analysis was used to analyze the relation between knowledge, attitude and compliance. Chi Square test was used to determine relation between various determinants and the knowledge and practice of Standard Precautions. Results: Mean knowledge, attitude and compliance scores among HCWs were 11.47 + 4.16, 7.09 + 1.46 and 10.72 + 2.57 respectively. A moderately positive correlation was observed between knowledge and attitude scores (r=0.421, p<0.001). Mean knowledge scores were higher for females, higher professional posts, those with previous Hepatitis B immunization and those with history of recent occupational exposure. Compliance scores were higher for females, for those with more professional post and in those with history of recent needle stick injury. A significantly greater number of females (p=0.02), trained HCWs (p=0.003), doctors & nurses (p=0.003), Hepatitis B immunised personnel (p=0.003) and those with history of recent occupational exposure (p<0.001) within the past 1 year had satisfactory knowledge scores. Similarly, significantly more number of female HCWs (p=0.004), nurses (p=0.001), experienced HCWs (p=0.01), and those with history of recent needle prick injury (p=0.04) achieved satisfactory compliance scores. Conclusion: The knowledge and compliance of Standard Precautions is generally poor. Pre- induction and periodic in- house training in Standard Precautions should be mandatory for all health care workers along with compulsory Hepatitis B immunization to reduce the risk of occupational exposure in the health care setting.

COVID-19 in Dental Practice: Transmission Risk, Infection Control Challenge, and Clinical Implications

Objective: The COVID-19 pandemic has become a worldwide, significant public health challenge. Dental care providers are at high risk due to the nature of their profession, which necessitates close proximity to the patient's oropharyngeal region and the use of droplet and aerosol-generating procedures. Methods: A review of the evolving literature on the COVID-19 pandemic was conducted. Published articles addressing SARS-CoV2 transmission modes and risks, and infection control procedures required in the dental office to protect dental patients and health care providers were assessed. Also, clinical guidelines on the management of dental patients during the pandemic were reviewed. Results: The established modes of transmission of SARS-CoV2 appear to be through respiratory droplets and through close contact with either symptomatic or asymptomatic patients. In addition to standard precautions of infection control widely followed in dental practices, extra precautionary measures are needed to control the spread of this highly infectious disease. Dental treatment during the pandemic is limited to emergent and urgent cases after a meticulous patient risk assessment and dental needs are triaged to minimize the risk of COVID-19 transmission and avoid cross-contamination. Conclusion: Dentists should be aware of the recently updated knowledge about COVID-19 modes of transmission and the recommended infection control measures in dental settings. Effective management protocols to regulate droplet and aerosol contamination in the dental clinic should be implemented to deliver dental care in a safe environment.

Knowledge, Health Belief, Self Efficacy and Performance on Standard Precautions of Infection Control in Nursing Students

Knowledge, Health Belief, Self Efficacy and Performance on Standard Precautions of Infection Control in Nursing Students

Two outbreaks of SARS-CoV-2 in department of surgery in a Wuhan hospital

SummaryThe outbreak of SARS-CoV-2 in China, attracted a large number of medical staff to help in the city's hospitals and this put them at a high risk of infection. We describe twenty medical staff who were diagnosed with COVID-19 within one week in the department of surgery in a Wuhan hospital. Epidemiological investigation of these cases identified misdiagnosed patients (source of infection), an inappropriate clinical meeting and working without wearing face masks to be the causes of the outbreaks. This report emphasizes the importance of wearing a facemask and applying other standard infection control precautions to protect medical personnel from infection with the virus.

Enhancing Nurses’ Knowledge and Skills in COVID19 through Learning Need Assessment

Preparedness of nurses who are in direct contact with COVID19 patients is a key as they can play a major role in preventing the spread of COVID-19. Enhancing nurses’ knowledge and practice to gain the maximum knowledge and skills related to COVID19 can make them more competent in protecting themselves, their patients, and their communities at large. The aim of this study is to identify nursing skills and knowledge deficits related to COVID19 to provide nurses with an education that enables them to provide safe and effective patient care. Method: A self-administered questionnaire containing socio-demographic data, knowledge domain, and skills domain (questions indicating their current knowledge and skills in COVID19 was distributed. Results: the majority of nurses at E1 cluster hospitals (n=1022) had brilliant knowledge and skills about COVID-19. The major performance gap was knowledge deficit related to infection control standards precautions. Conclusion: Nurses should enhance their knowledge related to infection control standard precautions and further studies are still needed to assess nurses’ attitudes as equal to knowledge and skills.

Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic - a narrative review.

Personal protective equipment has become an important and emotive subject during the current coronavirus disease 2019 epidemic. Coronavirus disease 2019 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately 1 metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from coronavirus disease 2019 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care - contact, droplet or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.

Justice in control of methicillin-resistant Staphylococcus aureus transmission: a fair question to ask?

Active surveillance cultures and contact precautions is a strategy to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare facilities. Whether to implement this strategy to routinely screen and isolate inpatients with MRSA in non-outbreak (endemic) settings, or to remove it and use standard infection control precautions only is scientifically and ethically controversial, in view of the potential adverse effects of contact precautions on patients. To support the use of standard precautions only, it has been argued that active surveillance to identify patients who are asymptomatically colonised with MRSA to place them in contact precautions is unjust or unfair to these patients in various ways. This paper will unpack and examine four distinct arguments, which are advanced from a medical ethics or quality improvement ethical framework, for why this is so. Our analysis shows that while these arguments highlight the injustice of current practices, they do not provide strong ethical reasons for justifying the removal of active surveillance and contact precautions to control MRSA transmission and infection. An implication of our arguments is that the ethical frame for evaluating prevention and control strategies for MRSA, a multi-drug resistant bacteria, should shift from healthcare to primarily public health. From a public health ethics perspective, whether a strategy is unjust, or how ethically significant its lack of fairness is, depends on assessing the evidence for its public health effectiveness and necessity in a given setting, and the extent of the harms and burdens patients with MRSA bear when they are on contact precautions, which remain matters of scientific debate or uncertainty. As an ethical consideration in the debate, the chief normative implication of justice is to provide us further reasons to revise current active surveillance-contact precautions practices, and for the need for research and interventions to minimise their potential adverse effects on patients.

Effect of Educational Program forNurses Performance Regarding Infection Control Precautions, toward patient on Mechanical Ventilation.

Background: Patients on mechanical ventilation have a greater risk of acquiring infections; however, this problem is greatest in critical care units. Aim: Evaluate effect of educational program for nurses Performance regarding to infection control standard precautions, for patients on mechanical ventilation. Study design: Quasi-experimental research design was utilized in this study. Setting: The study was conducted in trauma ICU and emergency ICU at Assiut University hospital. Sample: A convenience sample of all available nurses. The sample size was 60 nurses. Tools: Utilizing two tools, Nurse's knowledge questionnaire and Observational checklist. Results: The majority of the studied Sample statistical significant difference between before and after educational program as regard to total nurses' knowledge and practice with P-value <0.001** .observed nurses' knowledge scores improved from 21.7% before the educational program to 75%after the educational program. In addition, the observed nurses' practice scores improved from 21.7%before the educational program to71.7%after educational program. Conclusion: Nurses` knowledge and practice regarding mechanical ventilation infection Control Standard Precautions in the trauma ICU and emergency ICU becomes to the satisfactory level after the educational program. Recommendation: Nurses need for continuous training programs to increase their performance regarding mechanical ventilation infection control standard Precautions.

Awareness and Practice of Standard Precaution for Infection Control among Student Nurses

Infection control is a critical concern in any health care setting among healthcare providerswhich include student nurses. The dearth of literature and studies among student nursesprompted the conduct of this study. This study sought to determine the awareness andpractice of standard precaution (handwashing, safe handling of needles and other sharpdevices, and disposal of contaminated materials) for infection control among student nurses.It also determined the relationship between awareness and practice on standard precaution forinfection control, the difference in the practice of standard precaution for infection controlwhen gender and year level were considered, and the predictors of practice of standardprecaution for infection control. Data were collected from 121nursing students comprising of2nd, 3rd and 4th years. Participants were obtained through purposive sampling, from one ofthe universities in the Philippines. Results showed that the awareness of the respondents wasvery high, practice of standard precautions for infection control in terms of handwashing andproper handling and disposal of contaminated materials were excellent, with very goodpractice in terms of safe handling of needles and other sharp devices. There was statisticallysignificant relationship between awareness and practice on standard precaution in terms ofproper handling and disposal of contaminated materials, wherein those with high awarenessare more likely to have a better practice. However, there was no significant relationshipbetween awareness and the practice of standard precautions for infection control in terms ofhandwashing and safe handling of needles and other sharp devices. Year level and gender didnot make any significant difference in the practice of standard precaution for infection control.However, year level and gender were significant predictors of practice of standard precautionfor infection control in terms of safe handling of needles and other sharp devices, whereinstudents in higher level tend to have a better practice. Awareness was a significant predictorof practice of standard precaution for infection control in terms of proper handling anddisposal of contaminated materials, wherein the higher the awareness the better is the practice.Standard precaution for infection control concept and proper practice should be introduced tothe students as early as their first year in the nursing program.

Knowledge and Compliance with Standard Precaution among Critical Care Nurses

Critical care nurses are the health care professionals who have the compulsion to protect critically ill patients against infection especially those who are immune compromised, in order to enhance their recovery, prevent deterioration in their health, and achieve high quality nursing care. Therefore, critical care nurses should have sound knowledge and strict adherence to infection control standard precautions. The objective of the study is to evaluate the level of knowledge and compliance towards standard precaution. A descriptive cross-sectional research design and non-probability purposive sampling with self-administered questionnaire was adopted among 81 critical care nurses of Manipal Teaching Hospital, Phulbari-11. The obtained data was coded and entered in SPSS program version 23 with descriptive and inferential statistics. The study depicted that more than half of respondent (59.3%) had adequate knowledge and (40.7%) had inadequate knowledge. Majority of the respondent had high compliance (mean= 3.93) and average compliance (mean= 3.44). The use of protective suit or gown had low compliance (mean=2.17) and use of eye patch or goggle had very low compliance (mean=1.37). This study shows significant association between knowledge and compliance with standard precaution. Teaching approaches must be focused toward intensifying further compliance especially with the use of protective equipment. Furthermore, environment that promotes standard precaution practices should be developed by the faculty.

Infection Control Knowledge and Practices of Obstetricians during Normal Labor in Maternity Hospitals in Alexandria: An Intervention Study

Background: Infections during labor and the puerperium are among the leading causes of maternal mortality and morbidity worldwide, accounting for about one tenth of the global burden of maternal deaths. The infection risk associated with care in labor rooms is probably quite high. Objective(s): The study was conducted to assess infection control (IC) knowledge and practices of obstetricians in maternity hospitals in Alexandria during normal labor and to design, implement and evaluate the effect of an intervention program on IC practices of obstetricians. Methods: A cross-sectional study design was conducted among 135 obstetricians followed by an intervention study (one group pretest-posttest design). All obstetricians were asked to fill a questionnaire for assessment of knowledge and were observed three times using a checklist for assessment of practice. A health education program was designed and implemented among obstetricians then practices of obstetricians were reassessed using the same checklist. Results: Nearly 90% of obstetricians in this study had a good level of knowledge regarding standard IC precautions. Nearly two thirds of obstetricians (65.9%) had poor level of practice while 34.1% had fair level of practice pre-intervention. Post-intervention, 46.7% of obstetricians had fair level of practice. Areas of poor practice were hand hygiene and use of PPE. The best area of improvement in post-intervention was hand hygiene while use of PPE did not improve much. Conclusion: There is a gap between knowledge of obstetricians regarding IC and their practices.

사단급 이하 의무시설 근무자의 감염관리 표준주의지침에 대한 지식, 태도와 수행도

사단급 이하 의무시설 근무자의 감염관리 표준주의지침에 대한 지식, 태도와 수행도

Effect of a Blood-Borne Diseases Prevention Program on Nurses' Performance in Pediatric Critical Care Units

Background: Prevention of percutaneous injuries and other blood exposures is an important step in preventing the transmission of blood-borne viruses to healthcare personnelAim of Study was to assess the effect of a prevention program for blood-borne diseases on nurses' performance for infection control standard precautions. Research Design: A quasi-experimental design was utilized. Study settings: the study conducted at Critical area (Neonatal Intensive Care Unit, Pediatric Intensive Care Unit in Children's Hospital affiliated to Ain Shams University Hospitals. Research Subject: included 45 nurses selected by simple random sample working in the previously mentioned settings. Tools of the data collection: A predesigned questionnaire sheet, Observational Checklists were used pre and post program implementation Results: revealed that there was a statistical significant difference between nurses' performance pre and post program for blood-born diseases. Conclusion a prevention program for blood-borne diseases had significant effect on nurses' performance for infection control. Recommendation it could be recommended that implement the designed prevention program for blood-borne diseases to all nursing staff in all pediatric settings

Dutch guideline for preventing nosocomial transmission of highly-resistant micro-organisms (HRMO) in long-term care facilities (LTCFs)

In 2012, the Dutch Working Party for Infection Control (WIP) issued the first Guideline for prevention of transmission of highly-resistant micro-organisms (HRMO) in Hospitals. The next step was to focus on long-term care facilities (LTCFs) both for nursing homes as for small-scale living facilities with nursing home care. These facilities providing care for residents with functional disabilities, chronical illnesses and cognitive disorders, such as dementia. The objective was to adapt the Guideline for prevention of transmission of HRMO in hospitals to LTCFs with a strong accent on living conditions and social interactions.Residents of LTCFs may be carriers of HRMO over a long period of time and most of the residents of the LTCF stay for extended periods of time. To respect individual living circumstances and to prevent unnecessary limitations in the social life of the residents due to the use of isolation measures, the WIP has chosen to describe infection control precautions per individual micro-organism instead of a ‘one size fits all’ method. The term “isolation” was therefore replaced by the term “additional” precautions. This guideline describes the screening policies for residents in LTCFs, definition and detection of HRMO carriage, standard and additional infection control precautions for HRMO positive residents, documentation and communication of HRMO carriage and discontinuation of additional infection control precautions. It also describes contact tracing of HRMO, environmental control/investigation, surveillance of HRMO and what is important when there is an outbreak.