SHEA/APIC: Multisociety Guidance for Infection Prevention and Control in Nursing Homes (10/28/2025)

  • This guidance document updates the 2008 SHEA/Association for Professionals in Infection Control and Epidemiology (APIC) guideline: Infection Prevention and Control in the Long-Term Care Facility and is intended to assist nursing homes in the United States in defining and implementing their infection prevention and control (IPC) programs and practices.
  • Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility.

Environmental Rounds Worksheet For Infection Prevention

This is a 5 page checklist that is intended for teams that are conducting infection prevention environmental rounding. It is designed for rounding in a hospital, but as a WORD-based document, can be adapted for other healthcare settings.

3 – Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Adult Day Care
Ambulatory (Outpatient) Care
Ambulatory Surgery
Assisted Living Facility (ALF)
Auditing / Observation / Monitoring / Assessment Tools
Behavioral Health Facilities
Checklist
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
Dental
Department of Health
Dialysis
Downloadable
English
Free
High Level Disinfection
Hospice and Palliative Care
Infection Preventionists
Injection Safety
Mobile Clinic
Non-Clinical / Indirect Healthcare Personnel
Nursing Home / Skilled Nursing Facility (SNF)
Pediatric / NICU
Personal Protective Equipment (PPE)
Physical Environment / Environment of Care (EOC)
Quality Improvement
Risk Assessment
SPICE
Standard Precautions
Sterile Processing

Instrument Reprocessing: High-Level Disinfection and Sterilization For The Infection Preventionist

This is an online course with 5 modules intended to provide infection preventionists with the understanding about how high level disinfection and sterilization are performed, how a facility can prevent infections due to improper reprocessing and how a facility can assure regulatory compliance. The modules are: 1) Physical Plant Design, 2) Spaulding Classification Scheme, 3) Decontamination, Precleaning, and Transport, 4) High-Level Disinfection (HLD), and 5) Sterilization Process.

SPICE

IPC Intermediate Level 

English 

Video

CNE

CEU

Infection Preventionist 

Ambulatory (Outpatient) Care 

Ambulatory Surgery 

Acute Care Rehabilitation Hospital or Long-term Care Acute Hospital (LTACH) 

Acute Care Hospital 

Pediatric/NICU 

Dental 

Personal Protective Equipment (PPE)

Physical Environment / Environment of Care (EOC)

Cleaning & Disinfection

High-Level Disinfection

Sterile Processing

Auditing/ Observation/ Monitoring/ Assessment Tools

Regulatory Compliance

Outbreak Investigation

Surgical Site Infection (SSI)

HICPAC Sample Root Cause Analysis Template: Reprocessing Flexible Endoscopes

Facilities can use this sample Root Cause Analysis as a template to develop their own tool to pinpoint and understand process breakdowns that resulted in a flexible endoscope reprocessing event with undesired outcomes.

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
Auditing / Observation / Monitoring / Assessment Tools
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Outbreak Investigation
Pediatric / NICU
Quality Improvement
Risk Assessment
Sterile Processing
Toolkit

HICPAC Sample Gap Analysis and Risk Assessment Tool: Reprocessing Flexible Endoscopes

Facilities can use these sample Gap Analysis and Risk Assessment Tools as templates to develop their own quality improvement tools to be used in conjunction with a complete facility flexible endoscope inventory and the manufacturer’s instructions for use (IFU) for each flexible endoscope. If reprocessing practices are found to have gaps, the tools will help facilities determine where those gaps are and help them create a prioritized plan of action to address and ameliorate them.

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
Auditing / Observation / Monitoring / Assessment Tools
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Pediatric / NICU
Quality Improvement
Risk Assessment
Sterile Processing
Toolkit

HICPAC Sample Facility Endoscope Inventory: Flexible Endoscopes

This is an EXCEL worksheet designed for facilities to use as a template to develop their own tool to track their flexible endoscope inventory and repair and maintenance log. This sample inventory is designed to be used in conjunction with the Repair and Maintenance Log. The inventory should be updated any time (1) there is a change in the status or cleaning protocol of a flexible endoscope; (2) a new flexible endoscope is purchased or (3) a flexible endoscope is decommissioned. It can be part of a facility’s risk assessment.

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
Auditing / Observation / Monitoring / Assessment Tools
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Pediatric / NICU
Quality Improvement
Risk Assessment
Sterile Processing
Toolkit

HICPAC Sample Competency Verification Tool: Reprocessing Flexible Endoscopes

Facilities can use this sample Competency Verification Tool as a template to develop their own tool to assess the competency of personnel tasked with processing all types of reusable flexible endoscopes and accessories. This sample tool is designed to be used in conjunction with the Audit Tool. Facilities are encouraged to use the tools together to verify competency and audit current practice as well as to ensure that their practices are consistent with “Essential Elements of a Reprocessing Program for Flexible Endoscopes – Recommendations of the Healthcare Infection Control Practices Advisory Committee.”

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
Auditing / Observation / Monitoring / Assessment Tools
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Pediatric / NICU
Sterile Processing
Toolkit

HICPAC Sample Audit Tool: Reprocessing Flexible Endoscopes

Facilities can use this sample Audit Tool document as a template to develop their own audit tool specific to their endoscopes and evidence-based reprocessing practices. This sample tool is designed to be used in conjunction with the Competency Verification Tool. Facilities are encouraged to use these tools together to verify competency and audit current practice as well as to ensure that their practices are consistent with “Essential Elements of a Reprocessing Program for Flexible Endoscopes – Recommendations of the Healthcare Infection Control Practices Advisory Committee.”

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
Auditing / Observation / Monitoring / Assessment Tools
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Pediatric / NICU
Sterile Processing
Toolkit

HICPAC Sample Policy Template for Reprocessing Flexible Endoscopes

This is a 5 page template for facilities who reprocess flexible endoscopes to adapt. It is based on AORN Guidance.

Intermediate
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Ambulatory (Outpatient) Care
Ambulatory Surgery
CDC
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
English
Free
High Level Disinfection
Infection Preventionists
Non-Clinical / Indirect Healthcare Personnel
Pediatric / NICU
Sterile Processing

Prevention CHKC (Course in Healthcare-Associated Infection Knowledge and Control)

This is a course created by the Society for Healthcare Epidemiology of America (SHEA). It is designed to train frontline personnel in best practices to prevent and control HAIs and pathogens that can spread in the healthcare setting. It consists of 11 modules (including prevention of CLABSI, CAUTI, SSI, VAP/VAE, C. difficile MRSA) and how to improve understanding of disinfection and sterilization. This is a course created by the Society for Healthcare Epidemiology of America (SHEA). It is designed to train frontline personnel in best practices to prevent and control HAIs and pathogens that can spread in the healthcare setting. It consists of 11 modules (including prevention of CLABSI, CAUTI, SSI, VAP/VAE, C. difficile MRSA) and how to improve understanding of disinfection and sterilization.

Foundational
ABIM-MOC
Activity Included
Acute Care Hospital
Acute Care Rehabilitation or Long-Term Care Acute Hospital (LTACH)
Air Quality
Antimicrobial & Diagnostic Stewardship
Assisted Living Facility (ALF)
Auditing / Observation / Monitoring / Assessment Tools
Central Line
Central line-associated bloodstream infections (CLABSI)
Cleaning and Disinfection
Clinical / Direct Healthcare Personnel
Closed Captioning
CME
CNE
Construction
COVID-19
Data Analysis
Emergency Preparedness & Operations
Employee/Occupational Health
English
Gastrointestinal Infections
Hand Hygiene
High Level Disinfection
Infection Preventionists
Interactive
Laboratory Collection and Interpretation
Multidrug-Resistant Organism (MDRO)
Nursing Home / Skilled Nursing Facility (SNF)
Outbreak Investigation
Paid
Personal Protective Equipment (PPE)
Physical Environment / Environment of Care (EOC)
Post-Training Support Materials
Quality Improvement
Respiratory Infections
Risk Assessment
SHEA
Standard Precautions
Sterile Processing
Surgical site infections (SSI)
Surveillance
Transmission-Based Precautions
Urinary Catheter
Urinary Tract Infections (UTI) & Catheter associated urinary tract infection (CAUTI)
Ventilator
Ventilator-associated events (VAE), including pneumonia (VAP)