CDC Program Offers Tools and Guidelines to Prevent Infections in Cancer Patients

The often-weakened immune systems of cancer patients receiving chemotherapy put them at greater risk of acquiring life-threatening infections in community and hospital settings, including during appointments for outpatient treatment.

To help clinicians, cancer patients, and their families prevent infections, the Centers for Disease Control and Prevention (CDC) is now offering a comprehensive program called “Preventing Infections in Cancer Patients.” The program was developed by oncology and infection-prevention experts from the CDC in collaboration with the CDC’s Healthcare Infection Control Practices Advisory Committee and the CDC Foundation.

The background information, interactive tools, and guidelines on the CDC’s interactive website, www.preventcancerinfections.org, “help patients take an active role in protecting themselves against infection and give doctors, nurses, and other clinicians necessary tools to better prevent infection,” said CDC Director Thomas Frieden, MD, MPH. “One of the unique aspects of the program is the targeted nature of the information to the patient, caregiver, or healthcare provider,” noted Christopher R. Friese, RN, PhD, AOCN®, Assistant Professor of Nursing at the University of Michigan. “The new website is a welcome, evidence-based resource for reducing the burden of these significant, costly, and avoidable infections.”

On the patient and caregiver side, interactive quizzes and a special fact sheet help patients recognize the warning signs of neutropenia and minimize their infection risk while they are receiving chemotherapy. “Cancer, the Flu, and You” answers important questions cancer patients, cancer survivors, and caregivers may have about seasonal flu and influenza, including special considerations given the higher risk of complications from these illnesses faced by patients and survivors. It also provides information about vaccination against influenza, and discusses other vaccines that cancer patients and survivors should know about.

On the healthcare side, the “Basic Infection Control and Prevention Plan for Outpatient Oncology Settings” includes key policies and procedures that healthcare providers and administrators can use to meet minimal expectations for patient safety in their institutions.

The CDC notes that the outpatient infection control and prevention plan “is intended to be used by all outpatient oncology facilities,” and it encourages facilities to adopt the policies and procedures outlined in the plan or tailor specific elements for use in their own institutions. The CDC emphasizes, however, that the plan “does not replace the need for an outpatient oncology facility to have regular access to an individual with training in infection prevention and for that individual to perform on-site evaluation and to directly observe and interact regularly with staff.”

Key recommendations focus on standard precautions in outpatient settings, such as:

Proper hand hygiene, including use of alcohol-based hand rubs and hand washing with soap and water.

Safe injection practices, including use of aseptic techniques when preparing and administering medications, and not reusing syringes and needles from patient to patient or re-entering them into medication vials.

Safe handling of potentially contaminated medical equipment, including proper cleaning and appropriate reprocessing of reusable medical equipment prior to use on another patient, and discarding after use of any equipment labeled for “single patient use.”

The “3 Steps Toward Preventing Infections During Cancer Treatment,” a resource for cancer patients receiving chemotherapy, their caregivers, and healthcare providers, can be accessed at www.preventcancerinfections.org. The plan, checklist, clinician and patient education materials, and additional information are available online.

The CDC cautions that the plan “is not intended to address facility-specific issues or other aspects of patient care,” for example infection-prevention issues that are unique to bone marrow transplant or stem cell transplant centers; occupational health requirements such as those regarding personal protective equipment for handling antineoplastic and hazardous drugs (as outlined by the Occupational Safety and Health Administration and the National Institute for Occupational Safety); appropriate preparation and handling of antineoplastic agents; and clinical recommendations for appropriate antimicrobial prescribing practices and neutropenia risk assessment in patients undergoing chemotherapy. However, further information on these topics is available in the CDC plan’s Appendix D, “Additional Resources.”