Nursing Home Decolonization Toolkit

Step 1: Adopt SHIELD program as Quality Assurance Performance Improvement (QAPI)

  1. QAPI Project Documentation Form (PDF) (DOC)
  2. Universal Plan of Care (PDF) (DOC)
  3. Resident Plan of Care (PDF) (DOC)

Step 2: What to Expect? (PDF) (DOC)

Step 3: Communication to Residents

  1. Admission Packet Letter (PDF) (DOC)
  2. Resident/Ombudsman Information Sheet (PDF) (DOC)

Step 4: Products & Protocols

  1. Products (PDF) (DOC)
  2. CHG Compatibility (PDF) (DOC)
  3. Protocol: Bed Bath With CHG Cloths (PDF) (DOC)
  4. Protocol: Bed Bath With CHG Liquid (PDF) (DOC)
  5. Protocol: Showering With CHG (PDF) (DOC)
  6. Protocol: Nasal Iodophor (PDF) (DOC)
  7. Order Set Examples (PDF)
  8. Admission – SHIELD Checklist (PDF) (DOC)
 Step 5: Staff Education & Training
  1. Paper or Computer Based Training (PDF) (PPT)
  2. Staff Post-Training Test and Answer Key: Basin Bed Bathing With CHG Liquid (PDF) (DOC)
  3. Staff Post-Training Test and Answer Key: CHG Cloths (PDF) (DOC)
  4. Physician and Staff Notification Flyer (PDF) (DOC)
  5. Staff Handouts for CHG Bathing/Showering (PDF) (PUB)
  6. Staff Handout for Basin Bed Bathing With CHG (PDF) (PUB)
  7. Staff Handout for Nasal Iodophor (PDF) (PUB)
  8. Staff Huddle Reminder Documents (PDF) (DOC)
  9. FAQ: General (PDF) (DOC)
  10. FAQ: Nasal Iodophor (PDF) (DOC)
  11. FAQ: CHG for Bathing (PDF) (DOC)
  12. FAQ: Wound Care (PDF) (DOC)
  13. FAQ: Do and Don’t (PDF) (DOC)

Step 6: Resident Education & Training

  1. Resident Handout for CHG Bed Bath (PDF) (PUB)
  2. Resident Handout for CHG Shower (PDF) (PUB)
  3. Resident Handout for Nasal Iodophor (PDF) (PUB)
  4. Waterproof Shower Poster for Residents (PDF) (DOC)
  5. Resident Talking Points: CHG (PDF) (DOC)
  6. Resident Talking Points: Iodophor (PDF) (DOC)

Step 7: Skills Assessments and Compliance Checks

  1. CHG Cloth Skills Assessment Checklist (PDF) (DOC)
  2. CHG Liquid Bed Bath Skills Assessment Checklist (PDF) (DOC)
  3. Resident Self-Showering Assessment (PDF) (DOC)
  4. Resident Self-Bed Bath Assessment (PDF) (DOC)

Step 8: Safety and Side Effects

  1. Safety and Side Effects (PDF) (DOC)
  2. Side Effect Tracking Form (PDF) (DOC)