epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Abstract

National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.

Disinfection with sodium hypochlorite in hospital environmental surfaces in the reduction of contamination and infection prevention: a systematic review

“…Although the direct relationship of the presence of Disinfection with sodium hypochlorite in hospital environmental surfaces in the reduction of contamination and infection prevention: a systematic review pathogens in these surfaces with the transmission of HAIs is not yet sufficiently clarified, at least in specific locations and situations disinfection actions are recommended, not just cleaning (9) . It is observed that despite being one of the most traditional disinfectants, hypochlorite remains studied and compared with other technologies and products.…”

“…However, a systematic review has shown that available studies do not yet allow a conclusion and, given the complex and multifactorial nature of HAIs, well-designed studies that systematically investigate the role of disinfecting surfaces in the transmission of infection are still needed (8) . In turn, the National Evidence-Based Guide Related to Infection Prevention in Health Care (epic3), instead of generalizing the treatment of any item recommend levels of cleaning or disinfection procedures, according to circumstances of use, contamination and occurrences of cases of colonization or infection (9) .…”

epic3: revised recommendation for intravenous catheter and catheter site care

“…Sir, In parallel with the NICE MTG review of Tegaderm 2% chlorhexidine (CHG) gel impregnated dressing (NICE, 2015) 1 , the Epic3 scientific advisors reviewed the evidence and wording of the recommendation relating to the use of CHG impregnated dressings (Loveday et al 2014) 2 which currently states:…”

A Prospective Study to Compare Routine versus Need Based Change of IV Cannula on Development of Infusion Phlebitis in Adult Surgical Patients

“…As recorded by Dr. R. Lewis [6], during the cholera epidemic of 1831-1832, Dr. Thomas Latta pioneered the use of IV infusion saline. In the 20th century, World War II saw extensive use of IV devices and firmly established IV therapy as an integral part of medical practice [7].…”

“…The consent form was written in Nepali for better understanding of the patient and in case of any doubt, and the entire information was verbally conveyed. The outcome assessments made were:  Pain: using (VAS) Visual Analog Scale [7].  Phlebitis: Using (V.I.P.)…”