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

Eikelenboom-Boskamp, Andrea; Haaijman, Jobje; Bos, Maria; Saris, Katja; Poot, Else; Voss, Andreas

doi:10.1186/s13756-019-0586-3

Antimicrobial Resistance & Infection Control

Table 5b Standard and additional infection control precautions by HRMO positive residents, per HRMO in a non-outbreak setting

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

HRMO or indication	Materials, instruments, devices used for care of HRMO positive resident	Cleaning and disinfection of room/bathroomⁿ			Disposal of materials
HRMO or indication		Cleaning	Disinfection	Terminal cleaning^o/ terminal disinfection^p	Waste or Laundry
Enterobacteriaceae (ESBL included, not CPE^a	No sharing with other residents^{q, r}	Daily	Yes, if used for other residents as well^s	Terminal cleaning procedure	Disposal in closed, intact bag
CPE^a	No sharing with other residents^{q, r}	Daily^t	Yes, if used for other residents as wel^s	Terminal disinfection procedure	Disposal in closed, intact bag
Acinetobacter species	No sharing with other residents^{q, r}	Daily^t	Yes, if used for other residents as well^s	Terminal disinfection procedure	Disposal in closed, intact bag
Pseudomonas aeruginosa	No sharing with other residents^{q, r}	Daily	Yes, if used for other residents as well^s	Terminal disinfection procedure, only sanitation room(s)	Disposal in closed, intact bag
Stenotrophomonas maltophilia	No sharing with other residents^{q, r}	Daily	Yes, if used for other residents as well^s	Terminal disinfection procedure, only sanitation room(s)	Disposal in closed, intact bag
Streptococcus pneumonia (PRP)	No sharing with other residents^{q, r}	Daily	Yes, if used for other residents as well^s	Terminal cleaning procedure	Disposal in closed, intact bag
Enterococcus faecium (VRE)	No sharing with other residents^{q, r}	Daily	Yes, if used for other residents as well^s	Terminal disinfection procedure	Disposal in closed, intact bag
Recent admission foreign HCF	No sharing with other residents^{q, r}	Daily^t	Yes, if used for other residents as well^s	Not applicable	Disposal in closed, intact bag

ⁿFor instructions for cleaning and disinfection of (bath) room: follow national guidelines
^oTerminal cleaning (or end-cleaning): cleaning of room (all surfaces, touch surfaces, floor, splashing zones of walls) including bathroom and all re-usable materials present in this room. Re-usable materials which cannot be cleaned and non-reusable materials will be discarded of. Terminal cleaning takes place if additional precautions are discontinued or when resident is discharged, transferred or deceased
^pTerminal disinfection (or end-disinfection): after terminal cleaning^o, terminal disinfection of the room is performed (all surfaces, touch surfaces, floor, splashing zone of wall) including bathroom facilities and other re-usable materials present in the room (e.g. curtains, remote control, etc.). A terminal disinfection takes place after the additional precautions of the HRMO positive resident are discontinued, or the resident is discharged, transferred or deceased. Re-usable materials which cannot be disinfected, should be discarded of
^qA small supply of necessary materials for the immediate care of the resident is allowed in the room/apartment. These materials must not be used for other residents and must be discarded after discharge or discontinuation of additional precautions
^rIf re-usable materials are used, they should be disinfected immediately when taken outside the resident’s room/apartment
^sE.g. resident lifting devices, stethoscope
^tUse cleaning material only for the room and devices of HRMO positive resident. Discard non-reusable cleaning material immediately after use. If the cleaning material is re-usable, remove materials after use in appropriate closed bag

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ISSN: 2047-2994

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