Hospital-Onset Bacteremia and Fungemia Playbook 

Healthcare-associated infections (HAIs), or infections acquired during hospital treatment, pose a persistent challenge for patient safety and trust, contribute to clinician burnout, and result in more than 70,000 deaths and $28 billion in direct medical costs every year. One type of HAI is hospital-onset bacteremia and fungemia (HOB), which is any bloodstream infection where bacterial or fungal pathogens are detected from a blood culture specimen collected on day four or later of hospital admission.The National Quality Forum (NQF), with support from Becton Dickinson (BD), convened an Expert Panel in early 2024 to develop guidance and best practices related to HOB prevention, identification, and treatment. The resulting Hospital-Onset Bacteremia and Fungemia Playbook is designed to help organizational leaders and clinical care teams in acute care settings implement or improve HOB management initiatives.This playbook helps healthcare organizations build on their existing infection prevention and control (IPC) practices and quality and patient safety initiatives. Drawing from decades of IPC research, it presents considerations and best practices so that organizations have options that can be tailored to their specific needs.