Quality standard

Quality statement 6: Educating people about infection prevention and control

Quality statement

People with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), are educated about the safe management of the device or equipment, including techniques to prevent infection.

Rationale

Because many people with a urinary catheter, vascular access device or enteral feeding tube manage their own device or equipment, it is important that they and their family members or carers are confident about, and proficient in, infection prevention and control practices and the safe management of the device or equipment.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements for people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), to be educated about the safe management of their device or equipment, including techniques to prevent infection.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, local protocols.

Process

Proportion of people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), who are educated about the safe management of their device or equipment, including techniques to prevent infection.

Numerator – the number of people in the denominator who are educated about the safe management of their device or equipment, including techniques to prevent infection.

Denominator – the number of people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate).

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

Outcome

a) Incidence of healthcare-associated infection.

Data source: 2020/21 NHS Outcomes Framework indicator 5.2 and 2020/21 CCG Outcomes Indicator Set indicators 5.3 and 5.4 measure incidence of methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile. Data are derived from UK Health Security Agency's mandatory reporting of healthcare-associated infections.

b) People with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), feel able to manage their device or equipment.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient surveys to demonstrate that patients and carers have understood their education.

What the quality statement means for different audiences

Service providers ensure that there are systems in place for people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), to be educated about the safe management of the device or equipment, including techniques to prevent infection.

Healthcare workers ensure that they educate people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), about the safe management of the device or equipment, including techniques to prevent infection.

Commissioners ensure that they commission services in which people with a urinary catheter, vascular access device or enteral feeding tube, and their family members or carers (as appropriate), are educated about the safe management of the device or equipment, including techniques to prevent infection.

People who have a urinary catheter, a vascular access device or an enteral feeding tube, and any family members or carers who help them with this equipment, are given information and advice about how to look after the equipment safely and effectively. This includes advice about how to prevent infection. Enteral feeding is a type of feeding used for people who cannot eat normally in which liquid food is given through a tube directly into the gut.

Definitions of terms used in this quality statement

Urinary catheter

A urinary catheter is a catheter that is inserted in the urethra and remains in place until it is no longer needed. Both short-term (used for 28 days or less) and long-term (used for more than 28 days) urinary catheters are used. [Adapted from NICE's full guideline on healthcare-associated infections and epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England]

Vascular access device

A vascular access device is an indwelling catheter, cannula or other instrument used to obtain venous or arterial access. Both central and peripheral vascular access devices are available. [Adapted from NICE's full guideline on healthcare-associated infections and epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England, table 3]

Enteral feeding

Enteral feeding is feeding via a tube that can include any method of providing nutrition via the gastrointestinal tract. [NICE's full guideline on healthcare-associated infections]

Education about infection prevention and control

Education for people and their carers about infection prevention and control should always cover the techniques of hand decontamination. In addition, education should be provided as follows:

For people with a urinary catheter, education should cover insertion of intermittent catheters where applicable, how to manage the catheter and drainage system, how to minimise the risk of urinary tract infections and how to obtain additional supplies suitable for individual needs. [NICE's guideline on healthcare-associated infections, recommendation 1.2.1.1, and epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England, recommendation UC22]

For people with a vascular access device, education should cover any technique needed to prevent infection and safely manage the device. [NICE's guideline on healthcare-associated infections, recommendation 1.4.1.1, and epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England, recommendation IVAD3]

For people needing enteral feeding, education should cover techniques of feeding and management of the administration system. [NICE's guideline on healthcare-associated infections, recommendation 1.3.1.1]

Equality and diversity considerations

People with a cognitive impairment or a lack of mobility may need additional support to undertake hand decontamination and other techniques to prevent infection. Language barriers should not be a reason for not providing advice.

If religious beliefs are a source of concern in relation to the use of alcohol hand rubs for hand decontamination, people could be made aware of the official views of religious bodies about the products. If information is available, people should be directed to these sources.