Current through Register Vol. 51, No. 19, September 20, 2024
A. The hospital shall have an active
hospital-wide program for the prevention, control, and investigation of
communicable diseases and infections.
B. Staffing.
(1) The hospital shall designate qualified
staff with training in infection prevention and control to be responsible for
the implementation of the infection prevention and control program.
(2) Additional clinical and support staff
shall be provided for the infection prevention and control program based on the
size and complexity of the hospital's services.
C. Infection Prevention and Control Program.
(1) The infection prevention and control
program shall be based on nationally recognized, evidence-based
standards.
(2) The infection
prevention and control program shall be developed using an interdisciplinary
approach with input from:
(a) Administrative
staff;
(b) Medical staff;
(c) Pharmacy staff;
(d) Laboratory personnel;
(e) Nursing staff;
(f) Physical plant personnel;
(g) Employee health personnel;
(h) Patient safety officer; and
(i) Staff from other departments whose
knowledge and experience would contribute to improved infection prevention and
control.
(3) Written
policies and procedures for the infection prevention and control program shall
be established, implemented, maintained, and updated periodically.
D. Surveillance.
(1) The hospital shall:
(a) Have a process for the identification and
surveillance of healthcare- associated infections;
(b) Analyze and utilize surveillance data to
monitor and improve infection control and healthcare outcomes; and
(c) Maintain a log of the identified
infections.
(2) The
infection prevention and control program shall include:
(a) Processes for the monitoring and control
of patients who have a communicable disease or infection to prevent its spread
to other patients and staff;
(b) A
process to identify and investigate the occurrence of outbreaks of communicable
diseases or clusters of infections; and
(c) Reporting of infections, communicable
diseases, and outbreaks to the local or State health department, as required by
COMAR 10.06.01.
(3) When
an outbreak occurs, the infection control staff shall have adequate resources
and authority to ensure comprehensive and timely investigation and to implement
control measures.
E.
Education.
(1) The hospital shall provide
education to all staff and, if appropriate, to the patient and visitors
regarding the prevention and control of communicable diseases and infections.
Educational activities shall address problems identified by the infection
prevention and control program.
(2)
Nonclinical staff shall be included in infection prevention and control
training consistent with their assigned responsibilities.
(3) Attendance or participation in an
educational program shall be recorded. Educational programs shall be evaluated
not less than annually for effectiveness.
(4) Education related to infection prevention
and control shall be included in the hospital's orientation program for all new
employees, including appropriate contractual personnel.
(5) Physicians who are employed or who have
privileges and who do not receive training through the hospital's new employee
training program shall receive alternative orientation education on infection
prevention and control practices and the hospital's infection prevention and
control program.
(6) Outside agency
staff shall receive sufficient training in the hospital's infection prevention
and control policies and procedures to provide safe care to the
patients.
F. Prevention.
(1) The hospital shall establish processes
and programs to prevent the spread of communicable diseases and
infections.
(2) A hospital's
processes and programs to prevent the spread of communicable diseases and
infections shall include at least the items listed in §F(3) of this
regulation.
(3) Required Processes
and Programs.
(a) Hand Hygiene.
(i) The infection prevention and control
program shall include activities to educate staff on the need for hand hygiene
prior to and after any patient contact and as directed by accepted professional
practice.
(ii) Hand hygiene
compliance by staff shall be monitored through the infection prevention and
control program.
(iii) The
infection prevention and control program shall maintain documentation of audits
for compliance with this requirement.
(iv) Facilities and supplies to facilitate
hand hygiene shall be provided and be accessible in all locations of the
hospital where patient care is provided.
(b) Sanitation.
(i) The hospital shall maintain a sanitary
environment to prevent the spread of communicable diseases and
infections.
(ii) The hospital shall
have systems to maintain the environment in a clean and sanitary
condition.
(iii) Systems shall be
provided to ensure that housekeeping, linen handling, waste disposal including
medical waste, food handling, ventilation systems, water systems, and pest
control meet acceptable federal and State standards and guidelines.
(c) Aseptic Technique. The
hospital shall use aseptic techniques to prevent infections, including surgical
site infections and device-associated infections.
(d) Immunocompromised Patients. The hospital
shall use professionally accepted procedures to protect immunocompromised
patients from infection.
(e)
Standard Precautions. The hospital staff shall use standard precautions and
other categories of isolation or precautions consistent with current Center for
Disease Control (CDC) recommendations.
(f) Equipment and Supplies.
(i) The hospital shall have personal
protective equipment, such as gloves, gowns, respirators, and masks or other
facial protection for staff readily available.
(ii) Supplies and equipment needed to prevent
the spread of communicable diseases and infections shall be available in all
patient care areas.
(4) Employee Health Program. The infection
prevention and control program shall work in conjunction with the employee
health program and include monitoring and identification of employee health
concerns such as immunity to measles, mumps, rubella, and varicella (chicken
pox).
(5) Immunizations for
influenza shall be offered to staff and licensed independent practitioners.
Reasons for refusal of the influenza vaccine by an employee shall be documented
by the infection control or employee health program.
G. Performance Improvement.
(1) The infection prevention and control
program shall include performance improvement and quality assurance measures to
address the problems identified through the surveillance, control, and
investigation of infections.
(2)
The hospital shall develop and implement interventions to address identified
problems and monitor the effectiveness of interventions to control and prevent
infections.
(3) The infection
prevention and control program shall be incorporated into the hospital's
performance improvement program.
H. Patient Safety. The infection prevention
and control program shall share data regarding healthcare-associated infections
with the hospital's designated patient safety officer. Health care associated
infections that meet the definition of a Level 1 adverse event shall be
reported to the Department, and a root cause analysis submitted as required by
COMAR 10.07.06.
I. Reports to the
Governing Body.
(1) Infection control data
including reports on the numbers and types of healthcare-associated infections
shall be reported to the hospital's medical staff and governing body on an
ongoing basis.
(2) The hospital
leadership shall support infection prevention and control activities, including
the provision of adequate resources for the program.
J. Department Oversight.
(1) The hospital shall comply with all data
reporting requirements of the Maryland Health Care Commission related to the
prevention and acquisition of infections in accordance with Health-General
Article, §19-134(e), Annotated Code of Maryland.
(2) The Department shall have access to all
data maintained through the hospital's infection prevention and control program
to determine the hospital's compliance with State and federal
regulations.