surgical site infection guidelines idsa

CAUTIs and CLABSIs: Do Physicians REALLY Know What They Are?  PJ. This book outlines the most updated clinical guidelines that are vital for the prevention infections and care of patients with joint infections following a replacement surgery, one of the highest volume medical interventions globally.  et al. Duration of Antimicrobial Therapy in Treating Complicated Intra-Abdominal Infections: A Comprehensive Review. Meakins JL, Solomkin JS, Allo MD, Dellinger EP, Howard RL, Simmons RL. © 2021 American Medical Association. Clinical evidence for the use of antifungal therapy for patients with suspected intra-abdominal invasive candidiasis is limited. Objective  The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization. Infection is the most common indication for revision in total knee arthroplasty28 and the third most common indication in total hip arthroplasty.28 By 2030, the infection risk for hip and knee arthroplasty is expected to increase from 2.18%22 to 6.5% and 6.8%, respectively.25 In addition, owing to increasing risk and the number of individuals undergoing prosthetic joint arthroplasty procedures, the total number of hip and knee prosthetic joint infections is projected to increase to 221 500 cases per year by 2030, at a cost of more than $1.62 billion.22,25 The Prosthetic Joint Arthroplasty section contains recommendations that are applicable to these procedures (eAppendix 1 of the Supplement). ), 6B. doi:10.1001/jamasurg.2017.0904. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Funding/Support: The Centers for Disease Control and Prevention (CDC) supported the development of the guideline. Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. Kurtz ), 2D. Erik Woelber, Emily J. Schrick, Bradford D. Gessner, Heather L. Evans Surgical Infections. Dec 2016, 17(6): 665-674. Like this: Like. Donald E. Fry Surgical Infections. Surgical Site Infections (SSI) TREATMENT . Dr Mazuski reported being a paid consultant for Bayer, Cubist Pharmaceuticals, Forest Laboratories, MedImmune, Merck/Merck Sharp and Dohme, and Pfizer; reported receiving lecture fees from Forest Laboratories, Merck/Merck Sharp and Dohme, and Pfizer; and reported that his institution received funding for his consultancy to AstraZeneca and grants from AstraZeneca, Bayer, Merck/MSD, and Tetraphase. Assessment of hepatitis B virus immunization status among North American surgeons. Matthew Byrnes, Rob Dorman Surgical Infections. ), 8B. Randomized controlled trial evidence suggested uncertain trade-offs between the benefits and harms regarding the administration of increased Fio2 via face mask or nasal cannula during only the postoperative period in patients with normal pulmonary function for the prevention of SSI. Apoptosis and necrosis: a review for surgeons. 11A. Necrotizing infection or severe sepsis or septic shock , or fever with neutropenia Localized infection, no systemic toxicity. ), 1D. Not hypotensive. ), 8A.1. This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety. Management usually takes the form of dressing changes to optimize healing, which … DiPiro JT, Edmiston CE, Bohnen JMA. (No recommendation/unresolved issue. Massimo Sartelli, Fausto Catena, Luca Ansaloni, Federico Coccolini, Salomone Di Saverio, Ewen A. Griffiths Surgical Infections. Surg. December 01, 2017 - of Surgical Site Infections Definition of Tight Glucose Control Tight glucose control refers to getting … for Prevention of Surgical Site Infections A 2017 guideline from the Centers for Disease Control and … Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017 …The association of diabetes and glucose control … Category IB: A strong recommendation supported by low-quality evidence suggesting net clinical benefits or harms or an accepted practice (eg, aseptic technique) supported by low to very low–quality evidence.  DE. The epidemiology of revision total knee arthroplasty in the United States. (Category IA–strong recommendation; high-quality evidence. World Journal Surg. Preoperative phase . To provide explicit links between the evidence and recommendations, a modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used for evaluating the quality of evidence and determining the strength of recommendations.12-15 The methods and structure of this guideline were adopted in 2009 by CDC and HICPAC.16,17 The present guideline does not reevaluate several strong recommendations offered by CDC’s 1999 Guideline for Prevention of Surgical Site Infection18 that are now considered to be accepted practice for the prevention of SSI.  et al. 1.  SE, Surgery,1 as well as guidelines from IDSA and SIS.2,3 The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the preven-tion of surgical-site infections (SSIs) based on currently available clinical evidence and emerging issues. Arch Surg. Therapeutics and Guidelines Chair 2019 - 2022, Contact Info: PO Box 1278 East Northport, NY 11731 Phone: 631.368.1880 Fax: 631.368.4466, Junior Faculty Basic or Translational Research Fellowship, Basic or Translational Research Training Fellowship Past Recipients, Junior Faculty Clinical Research Fellowship, SIS Junior Faculty Fellowship Award Past Recipients, SIS Evaluative Research Fellowship Award Past Recipients. May 2017, 18(4): 377-378. 1998; 26:392-408. Surgical site infections can sometimes be superficial infections involving the skin only. July 2, 2014. ), 19. ), 6C. Group Information: The Healthcare Infection Control Practices Advisory Committee (HICPAC) members are as follows: Hilary M. Babcock, MD, MPH, Washington University School of Medicine in St Louis; Dale W. Bratzler, DO, MPH, The University of Oklahoma Health Sciences Center; Patrick J. Brennan, MD, University of Pennsylvania Health System; Vickie M. Brown, RN, MPH, WakeMed Health & Hospitals; Lillian A. Burns, MT, MPH, Greenwich Hospital; Ruth M. Carrico, PhD, RN, CIC, University of Louisville School of Medicine; Sheri Chernetsky Tejedor, MD, Emory University School of Medicine; Daniel J. Diekema, MD, University of Iowa Carver College of Medicine; Alexis Elward, MD, Washington University School of Medicine in St Louis; Neil O. Fishman, MD, University of Pennsylvania Health System; Ralph Gonzales, MD, MSPH, University of California, San Francisco; Mary K. Hayden, MD, Rush University Medical Center; Susan Huang, MD, MPH, University of California Irvine School of Medicine; W. Charles Huskins, MD, MSc, Mayo Clinic College of Medicine; Lynn Janssen, MS, CIC, CPHQ, California Department of Public Health; Tammy Lundstrom, MD, JD, Providence Hospital; Lisa Maragakis, MD, MPH, The Johns Hopkins Hospital; Yvette S. McCarter, PhD, University of Florida Health Science Center; Denise M. Murphy, MPH, RN, CIC, Main Line Health System; Russell N. Olmsted, MPH, St Joseph Mercy Health System; Stephen Ostroff, MD, US Food and Drug Administration; Jan Patterson, MD, University of Texas Health Science Center, San Antonio; David A. Pegues, MD, David Geffen School of Medicine at UCLA; Peter J. Pronovost, MD, PhD, The Johns Hopkins University; Gina Pugliese, RN, MS, Premier Healthcare Alliance; Selwyn O. Rogers Jr, MD, MPH, The University of Texas Medical Branch; William P. Schecter, MD, University of California, San Francisco; Barbara M. Soule, RN, MPA, CIC, The Joint Commission; Tom Talbot, MD, MPH, Vanderbilt University Medical Center; Michael L. Tapper, MD, Lenox Hill Hospital; and Deborah S. Yokoe, MD, MPH, Brigham & Women’s Hospital. Arch Surg.  JA, Agarwal ), 14. Surgical Hand Antisepsis and Surgical Site Infections. This textbook provides a clinically oriented, compact and up-to-date overview on infections in hematology patients and their management. (No recommendation/unresolved issue. Charles E. Edmiston Jr., David J. Leaper Surgical Infections. The AAP's authoritative guide on preventing, recognizing, and treating more than 200 childhood infectious diseases. The treatment of intraabdominal infections (IAI) is well established and based on current guidelines published by the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), the 2018 Tokyo Guidelines (TG18), and the World Society of Emergency Surgery (WSES). This guideline focuses on select areas for the prevention of SSI deemed important to undergo evidence assessment for the advancement of the field. Itani Surgical Infections. Dr Segreti reported receiving lecture fees from Pfizer, Merck, and Forest Laboratories and reported owning stocks in or having stock options from Pfizer. © 2021 American Medical Association. (Category II–weak recommendation; moderate-quality evidence suggesting a trade-off between clinical benefits and harms. ), 1B. 9. No guideline can cater for all variations in ecology, antimicrobial resistance patterns, patient characteristics and presentation, health care and reimbursement systems in many different countries.  E, This book provides a c None received compensation outside of their usual salary. Surg Infect (Larchmt). This guideline covers preventing and treating surgical site infections in adults, young people and children who are having a surgical procedure involving a cut through the skin. 2009 Oct;10(5):467-99. By continuing to use our site, or clicking "Continue," you are agreeing to our, Figure. Further input was provided by HICPAC during a public teleconference in May 2015. Consider intraoperative irrigation of deep or subcutaneous tissues with aqueous iodophor solution for the prevention of SSI. Antimicrobial Formulation and Delivery in the Prevention of Surgical Site Infection. (Category II–weak recommendation; moderate-quality evidence suggesting a trade-off between clinical benefits and harms. Available evidence suggested uncertain trade-offs between the benefits and harms of the use and timing of preoperative intra-articular corticosteroid injection on the incidence of SSI in prosthetic joint arthroplasty. Guidelines on antibiotic use for the prevention of surgical site infections … Economic burden of periprosthetic joint infection in the United States. The activities of Drs Umscheid, Kelz, and Morgan and Mr Leas were supported through a short-term detail under contract at CDC (10IPA1004117, 10IPA1004133, 11IPA1106551, 11IPA1106555, and 11IPA1106565). Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated. Now in its Sixth Edition, the book continues to provide readers with the latest information in the field of healthcare epidemiology, infection control, patient safety, and the prevention and control of HAIs. The following BHIVA guidelines are available at BHIVA.org: HIV-associated malignancies (2014) Management of HIV infection in pregnant women 2012 (2014 interim review) Management of hepatitis viruses in adults infected with HIV 2013 (Update Sept 2014) Treatment of HIV-1 positive adults with antiretroviral therapy 2015. Administer the appropriate parenteral prophylactic antimicrobial agents before skin incision in all cesarean section procedures. Quiz Ref IDPerform intraoperative skin preparation with an alcohol-based antiseptic agent unless contraindicated. A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The degree of risk for a surgical site infection is related to the type of surgery and whether an infection is present at the time of surgery. The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and effective useof antimicrobial agents for the prevention of surgical-site infections (SSIs) … Improving risk-adjusted measures of surgical site infection for the National Healthcare Safety Network. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI. (No recommendation/unresolved issue.). It focuses on methods used before, during and after surgery to minimise the risk of infection. Christou NV, Barie PS, Dellinger EP, Waymack JP, Stone HH. The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention.  E, Watson 1992; 127:83-89. 2007 Mar 1;44(5):705-10. We used DFI definitions based on the IDSA guidelines criteria, ... Firstly, prevention against surgical site infection 26 following major amputation, not specifically in DFI.  TC, Pearson (No recommendation/unresolved issue. An Analysis of Past Surgical Infection Society Award Recipients. US Government Printing Office. Design and conduct of antibiotic trials - A report of the scientific studies committee of the Surgical Infection Society.  HJ; GRADE Working Group. OR PCN allergy: Clindamycin 600 mg IV q8h . Cefazolin 1 g IV q8h . No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of ... CDC updated that version of the guideline using GRADE as the evidence-based method that provides the foundation of the recommendations in this guideline. In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision. The authors advocate the addition of two preventative strategies to the current United State’s guidelines for the prevention of surgical site infections. CDC indicates Centers for Disease Control and Prevention; GRADE, Grading of Recommendations, Assessment, Development, and Evaluation; RCTs, randomized controlled trials; SRs, systematic reviews; and SSI, surgical site infection. Updating the guideline methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC). I also want to emphasize that these guidelines are not about prevention, which is separate. These areas of focus were informed by feedback received from clinical experts and input from the Healthcare Infection Control Practices Advisory Committee (HICPAC), a federal advisory committee to the Centers for Disease Control and Prevention (CDC). NICE Guidelines [CG74], published October 2008. The most recently published guideline for prevention of SSIs was released in 1999 by Mangram et al.17 The CDC and HICPAC are currently working on an up- This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety. Meningitis (post-surgical) Staphylococcus aureus (MRSA and MSSA) Staphylococcus epidermidis Gram-negatives (i.e. Drafting of the manuscript: Berríos-Torres, Umscheid, Leas, Stone, Kelz, Reinke, Morgan, Itani, Berbari, Segreti, Blanchard. Final rules and interim final rule with comment period. May 2017, 18(4): 379-382. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with. The search did not identify randomized controlled trials that evaluated soaking prosthetic devices in antimicrobial solutions before implantation for the prevention of SSI. Ideally, this means levels between 70 and 130 mg/dL before meals, and less than 180 mg/dL 2 hours after starting a meal, with a glycated hemoglobin A1C level less … Stop smoking at least 2 weeks before surgery* 2. Found inside – Page 766The Infectious Disease Society of America (IDSA) defines infection as the presence of at least two of the following ... of surgical wound infection used in prospective studies, noted 41 different definitions of surgical wound infection. Dellinger EP, Wertz MJ, Meakins JL, Solomkin JS, Allo MD, Howard RJ, Simmons RL. (No recommendation/unresolved issue. Before surgery, patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the operative day. Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C; Therapeutic Agents Committee of the Surgical Infections Society. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. IDSA Guidelines on Surgical-Site Infection; Show All; Medication. OR Involvement of hardware: … Hospital-acquired infections (HAIs were defined using CDC guideline.) To provide new and updated evidence-based recommendations for the prevention of SSI. February 24, 2017 qemicro Leave a comment. Mu Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation. Of 5759 titles and abstracts screened, 896 underwent full-text review by 2 independent reviewers. Administrative, technical, or material support: Berríos-Torres, Bratzler, Leas, Stone, Morgan, Itani, Parvizi. The use of extended-interval aminoglycoside dosing strategies for the treatment of moderate-to-severe infections encountered in critically ill surgical patients. Recently, the 2016 IDSA clinical practice guidelines for the management of candidiasis were developed and explicitly addressed candidal peritonitis. © 2021 Applied Medical Resources Corporation. Patrick B. O'Neal, Kamal M.F. [Guideline] Ling ML, Apisarnthanarak A, Abbas A, Morikane K, Lee KY, Warrier A, et al. ), 8D. Previous Guideline. Results of the entire study selection process are shown in the Figure. developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. 1994; 129:27-32. (No recommendation/unresolved issue. Centers for Disease Control and Prevention. The AAP's authoritative guide on preventing, recognizing, and treating more than 200 childhood infectious diseases.  Y, Schünemann Application of autologous platelet-rich plasma is not necessary for the prevention of SSI. Antimicrobial Bowel Preparation for Elective Colon Surgery.  KB, Kaye Results of multicenter trial comparing imipenem/cilastatin to tobramycin/clindamycin for intra-abdominal infections. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections. Statistical analysis: Berríos-Torres, Umscheid, Leas. Topics: Guidelines, Sterilization and Disinfection, Surgical Site Infections, Infection Prevention Abstract: These ASHP, SHEA, IDSA, and SIS clinical practice guidelines provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical-site infections based on available clinical evidence and … Empiric Antimicrobial Therapy in Critical Illness: Results of a Surgical Infection Society Survey. Surgical Infection Society Curriculum Development Symposium: An Overview. (Category IA–strong recommendation; high-quality evidence.). American Surgical Site Infection. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017 | Critical Care Medicine | JAMA Surgery | JAMA Network This guideline provides new and updated evidence-based recommendations for the prevention of surgical site infections. Dr Itani reported that his institution received grants from Merck, Cubist, Dr Reddy’s, Sanofi Pasteur, and Trius for research trials; reported clinical advisory board membership at Forrest Pharmaceuticals; and reported payment for development of educational presentations for Med Direct and Avid Education. McKibben Study concept and design: Berríos-Torres, Umscheid, Bratzler, Leas, Stone, Kelz, Morgan, Mazuski, Dellinger, Itani, Berbari, Parvizi, Blanchard, Kluytmans. Surgical Perspective: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection 2017. A proposed classification of intra-abdominal infections: stratification of etiology and risk for future therapeutic trials. The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection. ), 15 and 16. ), 9B. Terms of Use| Aarts MA, Granton J, Cook DJ, Bohnen JM, Marshall JC. Antimicrobial prophylaxis should be administered only when indicated based on published clinical practice guidelines and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made. Dr Allen reported receiving lecture fees from Ethicon and royalties from Wolters Kluwer as an author for Infection Control: A Practical Guide for Healthcare Facilities. (Category IA–strong recommendation; moderate-quality evidence. This volume is of interest to neurosurgeons, endocrinologists, paediatricians, radiologists and oncologists. This volume focuses on adult craniopharyngiomas, offering various perspectives. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. Ben Kautza, Brian S. Zuckerbraun Surgical Infections. Type of Infection Suspected Organisms Recommended Treatment Burn Wounds S. aureus, P. aeruginosa • Surgical debridement is essential for clinical cure • Topical antimicrobials may be beneficial, directed by Burn surgeons/Dermatology • Systemic prophylactic antibiotics are not routinely recommended outside of surgical site infection prophylaxisπ CDC posted notice in the Federal Register for the following 2 periods of public comment: from January 29 to February 28, 2014, and from April 8 to May 8, 2014. Ban, Joseph P. Minei, Christine Laronga, Brian G. Harbrecht, Eric H. Jensen, Donald E. Fry, Kamal M.F. ), 2A.2. ), For patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation, administer increased, Perform intraoperative skin preparation with an alcohol-based antiseptic agent unless contraindicated. Joseph D. Forrester, Haiwei Henry Guo, Thomas G. Weiser Surgical Infections. In February 2013, the US Surgical Infection Society (“SIS”), the Society for Hospital Epidemiologists of America (“SHEA”), the Infectious Disease Society of America (“IDSA”) and the American Society of Hospital Pharmacists (“ASHP”) published new guidelines recommending that in the US all Staphylococcus aureus (including MRSA) should be decolonised in all cardiovascular …  E.  Systematic review of economic analyses of health care–associated infections. I. Bozic This book focuses on the epidemiology, diagnosis and management of Healthcare-Associated Infections (HAIs) in children. Joseph S. Solomkin, John Mazuski, Joan C. Blanchard, Kamal M.F. Antimicrob Resist Infect Control . Dr Kluytmans reported being a paid consultant for 3M, Johnson & Johnson, and Pfizer. National Health Statistics Reports 11. Antimicrobial Stewardship: A Call to Action for Surgeons. Provide nutrition therapy in malnourished patients scheduled for major operation 3. IDSA Surgical Wound Infection Algorithm Algorithm for the management and treatment of surgical site infections (SSIs). IDSA Releases New Surgical-Site Infections Guidelines. Non-Retracting Incision Donald E. Fry Surgical Infections. Surgical site infections can have a significant effect on quality of life for the patient. Conclusions and Relevance  This book is the first available practical manual on the open abdomen. Ann. Surg Infect (Larchmt).  et al; Heathcare Infection Control Practices Advisory Committee. APSIC guidelines for the prevention of surgical site infections. Surg Infect (Larchmt). Available evidence suggested uncertain trade-offs between the benefits and harms of systemic corticosteroid or other immunosuppressive therapies on the risk of SSI in prosthetic joint arthroplasty. US Department of Health and Human Services. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI.  et al. It is still discussed if the … Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section. Intraperitoneal lavage with aqueous iodophor solution in contaminated or dirty abdominal procedures is not necessary.  R, Vist Bohnen JMA, Solomkin JS, Dellinger EP, Bjornson HS, Page CP. Valuable insights into the pathophysiological mechanism of bacterial CNS infections A multidisciplinary reach that provides critical information for neurologists, neurosurgeons, and specialists in infectious disease Considerable information ... Surgical Management of Clostridium difficile Infection: The Role of Colectomy. The search did not identify randomized controlled trials that evaluated lower (<200 mg/dL) or narrower blood glucose target levels than recommended in this guideline nor the optimal timing, duration, or delivery method of perioperative glycemic control for the prevention of SSI. Updating the guideline development methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC). Found insideHospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infections. ... of America (SHEA) and the Infectious Diseases Society of America (IDSA) also have published SSI preventive guidelines, ...  MN. The Surgical Infection Society's policy on human immunodeficiency virus and hepatitis B and C infection-The ad hoc committee on acquired immunodeficiency syndrome and hepatitis. ), 1A.2. Quality standard for prophylactic antimicrobial use in surgical procedures. eAppendix 1. An approach to the evaluation of quality indicators of the outcome of care in hospitalized patients, with a focus on nosocomial infection indicators. It is known that Staphylococcus aureus, including Methicillin-resistant Staphylococcus aureus (MRSA), carriers are at a higher risk for the development of infections and they can easily transmit the organism. The update of the Guidelines for Treatment of Drug-susceptible Tuberculosis and Patient Care is important in the context of the End TB Strategy, which recommends treatment and patient support for all people with TB. This update aims to use ... 1997; 184:540-552. Archives of Neurology & Psychiatry (1919-1959), http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf, http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf, http://www.cdc.gov/nchs/data/nhsr/nhsr011.pdf, https://health.gov/hcq/prevent-hai-action-plan.asp, http://www.gpo.gov/fdsys/pkg/BILLS-109s1932enr/pdf/BILLS-109s1932enr.pdf, http://www.cdc.gov/hicpac/pdf/guidelines/2009-10-29HICPAC_GuidelineMethodsFINAL.pdf, https://www.hcup-us.ahrq.gov/nisoverview.jsp, FDA Approval and Regulation of Pharmaceuticals, 1983-2018, Global Burden of Skin Diseases, 1990-2017, Health Care Spending in the US and Other High-Income Countries, Life Expectancy and Mortality Rates in the United States, 1959-2017, Medical Marketing in the United States, 1997-2016, Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter, US Burden of Cardiovascular Disease, 1990-2016, US Burden of Neurological Disease, 1990-2017, Waste in the US Health Care System: Estimated Costs and Potential for Savings, Register for email alerts with links to free full-text articles.

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