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​Enhanced Standard Precautions (ESP)

Enhanced Standard Precautions (AFL 22-21) (PDF) is a resident-centered and activity-based approach for preventing MDRO transmission in skilled nursing facilities (SNF).​ The use of gowns and gloves by healthcare personnel during specific high-contact care activities is based on periodic assessments of a resident's risk for being colonized and transmitting MDRO, whether or not the resident is known to be MDRO-colonized or -infected by assessing patient for indwelling devices and unhealing wounds​.

ESP Taped Learning Modules 

This webinar series will provide SNF health care personnel and local health departments (LHD) with a review of ESP principles to reduce multidrug-resistant organism (MDRO) transmission in SNF and strategies to implement the recommended practices. Participants will receive instruction on how to use the ESP toolkit.


 Infection preventionists, directors of staff development, facility leadership, and LHD.


  • Review how ESP can prevent MDRO transmission in SNFs 
  • Describe the 6 moments of ESP
  • Discuss the steps that are taken to implement ESP in SNFs 
  • Describe how to use the ESP Toolkit to implement a SNF ESP Program

Earn CEU 

Provider approved by the California Board of Registered Nursing, Provider Number 17280, for 2.0 contact hours per course. Additional credit will not be issued for repeated courses.

ESP Office Hours

The ESP Office Hours provide an opportunity for SNF health care personnel to pose questions about ESP implementation at their facility via Zoom. Sessions will include HAI Program instructors discussing course content and application of materials. Facilities will be provided an opportunity share their challenges and successes with other facilities. Space is limited and sessions require registration via LearningStream.​

Register via Zoom for the ESP Office Hour Meetings on June 20, 2023 3PM - 4PM​​

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