Review - Reviewer's Assessment

1. Short summary / abstract
The report provides guidance on infection prevention and control precautions that should be applied by healthcare staff while caring for all patients in the hospital environment. The recommendations are divided into four interventions: -
Intervention 1: Standard principles for hospital environmental hygiene
Intervention 2: Standard principles for hand hygiene
Intervention 3: Standard principles for the use of personal protective equipment
Intervention 4: Standard principles for the safe use and disposal of sharps
The recommendations are not detailed practice protocols and therefore should be incorporated into local infection control policies/guidelines.
This guidance has been published in the Journal of Hospital Infection, the British Journal of Infection Control and on the NICE (http://www.nice.org.uk/) and EPIC (http://www.epic.tvu.ac.uk/) website.


2. What question is the document addressing?
The guidelines were developed to help prevent healthcare associated infections in secondary care settings and to provide the evidence to inform local policy and guidelines development for standard infection control precautions on the topics reviewed.

3. Type of study
Systematic review with critical assessment of the evidence

4. Methods valid & appropriate?
Yes

Comments:
The guidance has been updated following a further systematic review of evidence and new technology1 but a critical assessment of the updated evidence indicates that the guidance remains robust, relevant and appropriate.

5. Results / recommendations reliable?
The guidance was developed using a systematic review and then critical appraisal for each intervention, graded using categories described by Eccles and Mason (2001) to define the strength of recommendations.

6. Any major problems and biases?
The original report did not include guidance on infection prevention when using urinary catheters/central venous lines. This has been addressed in the update report which now includes: - Preventing urinary tract infections associated with insertion and management of short term indwelling urethral catheters Preventing infections associated with the insertion and maintenance of central venous catheters

7. Any other important / relevant studies which confirm or contradict?
1. The epic project. Updating the evidence-base for national evidence-based guidelines for preventing healthcare-associated infections in the NHS hospitals in England: a report with recommendations. PellowCM, Pratt RJ, Loveday HP, Robinson N, Jones SRLJ. British Journal of infection Control, December 2004, Vol 5 No. 6
2. Infection Control: Prevention of Healthcare-associated Infection in Primary and Community Care. Pellow CM, Pratt RJ, Harper P, Loveday HP, Robinson N, Jones S, MacRae ED and the Guideline Development Group. (2003) Journal of Hospital Infection 55(Supplement 2): 1-127 Winning Ways: Working together to reduce Healthcare Associated Infections in England, A report from the Chief medical Officer. www.dh.gov.uk/cmo


8. Keywords
Healthcare–associated infections infection prevention evidence-based guidelines hospital environmental hygiene urinary catheters central venous catheters



Reviewer's Details:

Name:Sue Wiseman
Post:Nurse Consultant –Infection Control, DH
Affiliations
(Society / Organisation / Advisory Committee):
Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association


*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.






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