Antimicrobial resistance (AR), including Clostridioides difficile infection (CDI), is a growing threat to public health and can spread across the healthcare continuum when patients move between facilities. Healthcare facilities can address AR in their region by working in conjunction with local public health and other facilities in their local healthcare network. The CDPH Healthcare-Associated Infections (HAI) Program works with healthcare facilities and local health departments (LHD) to convene regionally-based projects to improve AR prevention measures across the continuum of care.
Emergency Department Antibiotic Resistance Prevention Collaborative (Statewide)
Imperial County Antibiotic Stewardship Collaborative*
Long Beach CRE Prevention Collaborative*
Orange County CDI Prevention Collaborative*
Riverside County / Desert Health Care District CDI Prevention Collaborative*
Sacramento Metropolitan Area CDI Prevention Collaborative*
San Francisco Bay Area CRE Prevention Collaborative*
Individuals and organizations (for example, healthcare systems or LHD) interested in convening AR prevention projects may choose to convene a collaborative that focuses on condition-specific topics (for example, reducing CDI or carbapenem-resistant Enterobacteriaceae (CRE)) or topics that are more broadly focused (for example, antimicrobial stewardship ). We encourage organizations to choose topics that are relevant to their region and their patient population. Collaborative participants may decide to meet on a regular (for example, quarterly) basis to develop and strengthen relationships, foster communication, and participate in training and education sessions.
The HAI Program is developing a toolkit to help guide and plan regional collaboratives in your area; the toolkit may be used to help guide project plan development. An draft copy is available upon request.
The following tools are available for use in a collaborative. The HAI Program may have additional educational material available for use and can offer content expertise upon request. Contact the HAI Program at HAIProgram@cdph.ca.gov.
Core Infection Prevention: Identify infection prevention opportunities for improvement. Periodically use the CDPH HAI Program Core Infection Prevention self-assessment tool (PDF) to assess your facility core infection prevention strategies.
Ventilator Module: Use the Ventilator Module (PDF) in conjunction with the Core Infection Prevention tool, as it pertains to your facility.
MDRO Module: Use the MDRO Module (PDF) in conjunction with the Core Infection Prevention tool, as it pertains to your facility.
For CDI Prevention: Target CDI prevention strategies by identifying opportunities for improvement. Periodically use the CDPH HAI Program Facility CDI self-assessment tool (PDF) to assess your facility CDI prevention practices.
For CRE Prevention: Target CRE prevention strategies by identifying opportunities for improvement. Periodically use the CDPH HAI Program Facility CRE self-assessment tool (PDF) to assess your facility CRE prevention practices.
CDC has general infection control assessment tools for hospitals, skilled nursing facilities, outpatient settings, and hemodialysis facilities.
Measuring adherence and providing feedback to staff are critical to a successful infection prevention program. Use the CDPH HAI Program tools for adherence monitoring.
What is Antibiotic-Resistant (AR) Bacteria? Infographic: Antibiotic resistance is explained using pictures
AR Infographic 1 page (English version - PDF)
AR Infographic 2 per page (English version - PDF)
AR Infographic 1 page (Spanish version -PDF)
AR Infographic 2 per page (Spanish version -PDF)
Do Antibiotics have side effects? Infographic: Side effects of antibiotic use explained using pictures
AR Infographic 1 page (English version - PDF)
Antibiotics Aren’t Always the Answer: Facts about the effects of using antibiotics inappropriately (English - opens in YouTube)
Antibiotics Aren’t Always the Answer: Facts about the effects of using antibiotics inappropriately (Spanish - opens in YouTube)
The Hospital ASP Implementation Toolkit and the Skilled Nursing Facility ASP Implementation Toolkit contain comprehensive details and practical examples for developing and implementing each of the core elements of ASP recommended by CDC.
Commitment Posters and Prescription Pads: Public commitment to antibiotic stewardship by clinicians has been shown to reduce rates of inappropriate antibiotic prescribing and increase awareness of appropriate antibiotic use. The below clinician commitment posters explain a prescribers’ commitment to antibiotic stewardship. Poster templates can be personalized with photos, signatures, and corporate/facility logos. Additionally, prescription pads for symptom relief may be provided to patients when antibiotics are not needed.
Commitment Poster- Single Provider (English version - PDF)
Commitment Poster - Single Provider (Spanish version - PDF)
Commitment Poster - Multiple Clinicians (English version - PDF)
Commitment Poster - Multiple Clinicians Group Photo (English version - PDF)
Commitment Poster - Single Provider For Urology (English version - PDF)
Commitment Poster - Single Provider For Hematology-Oncology (English version - PDF)
Prescription Pad - Symptom Relief for Viral Illness (English version - PDF)
Prescription Pad - Symptom Relief for Viral Illness (Spanish version - PDF)
Prescription Pad - Watchful Waiting (English version - PDF)
Prescription pad - Watchful Waiting (Spanish version - PDF)
The MITIGATE toolkit (developed by May et al.) is a step-by-step implementation guide for healthcare providers and administrators interested in designing quality improvement programs in antimicrobial stewardship in emergency department (ED) and urgent care healthcare settings.
Guidance for antibiotic stewardship in dentistry (PDF) is available from the California Dental Association .
Communicating AR/CDI status ahead of time when transferring a patient/resident helps ensure appropriate infection prevention measures are maintained at the receiving facility. A template CDPH Interfacility Infection Control Transfer Form is available via the Interfacility Transfer Communications Guide page.
The HAI Program provides consultative support to coordinate regional prevention collaboratives. Contact us at HAIProgram@cdph.ca.gov.