Effective and practical measures to prevent infection outlined by NICE
GPs and other healthcare professionals should decontaminate their hands immediately after direct contact with patients to prevent the spread of infection in healthcare settings, says NICE.
Around 300,000 patients acquire healthcare-associated infections (HCAIs) each year as a result of care on the NHS.
Certain HCAIs can be deadly. Clostridium difficile and the ‘superbug' methicillin-resistant staphylococcus aureus (MRSA) led to approximately 9,000 deaths in hospital and primary care in England in 2007.
The cost of HCAIS to the NHS is estimated to be around £1 billion a year, with £56 million of this thought to be incurred once patients have been discharged from hospital.
NICE has updated its guidance on infection control to take into account new evidence since it was originally published in 2003.
The updated guidance also reflects the fact that more and more patients are being seen in primary care and more complex issues are being dealt with by GPs and practice nurses.
The guideline says that hands must be decontaminated immediately before every episode of direct contact with patients, and that this should now include aseptic procedures as well.
Furthermore, hands should be decontaminated after every episode of direct patient contact or care, after to any exposure to body fluids, after contact with a patient's surroundings that could potentially result in hands being contaminated, and immediately after gloves are removed.
GPs and healthcare workers should ensure their hands are decontaminated throughout the duration of clinical work.
They should do this by being bare below the elbow when giving direct patient care, removing wrist and hand jewellery, ensuring fingernails are short, clean and free of nail polish, and by making sure cuts and abrasions are covered with waterproof dressings.
Guidelines on techniques for effective handwashing remain unchanged. However, in a further update, it is recommended that GPs and healthcare workers ensure that gloves that have been exposed to body fluids and could be contaminated are disposed of correctly, and in accordance with national legislation and local policies.
Used sharps should be discarded immediately by the person generating the sharps waste. The sharps should be disposed of into a sharps container that conforms to current standards.
Additionally, all healthcare workers, including those in community settings must have available appropriate supplies for decontamination.
Patients and carers should be educated about hand decontamination. This should cover the benefits of hand decontamination, correct techniques and timing over when it is appropriate to use liquid soap and water or handrub, the availability of hand decontamination facilities, and what their roles are in maintaining standards.
Dr Julian Spinks, a GP and member of the Guideline Development Group for this update, said: “At a time where increasingly complex procedures are being provided in primary care, infection control is becoming more and more important.
“This guideline provides information about effective and practical measures that primary care clinicians can take to reduce the burden of healthcare-associated infection and forms an important part of the armoury for those of us who wish to provide high quality care in the community.”
28 March 2012