Around 300,000 people get an infection while being cared for within the NHS in England each year. These ‘healthcare associated infections' include pneumonia and infections of the lower respiratory tract (22.8%), urinary tract infections (17.2%) and surgical site infections (15.7%) [i].

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “It is unacceptable that infection rates are still so high within the NHS. Infections are a costly and avoidable burden. They hinder a patient's recovery, can make underlying conditions worse, and reduce quality of life.”

One in 16 people being treated on the NHS picks up an infection. As a result, more NHS resources are consumed and the affected patients are at increased risk. [ii]

Infections can occur in otherwise healthy people, especially if invasive procedures or devices like urinary catheters or vascular access devices [iii] are used. These infections can also be passed on to healthcare workers, family members and other carers.

NICE has produced a set of specific, concise and measurable statements (based on the institute's guidance and other guidance accredited by NICE). When delivered collectively, the statements should improve the effectiveness, quality, safety and experience of care that people get.

The quality standard contains 6 statements, including:

• People are prescribed antibiotics in accordance with local antibiotic formularies - as part of a system to stem resistance of infections to antibiotics (this is known as antimicrobial stewardship)^iv.
• Patients are looked after by healthcare workers who always clean their hands thoroughly, both immediately before and immediately after contact or care.
• Healthcare workers minimise the risk of infection to people who need a urinary catheter or a vascular access device by following procedures to make sure they are inserted, looked after and removed correctly and safely.

These procedures include cleaning hands, assessing the need for a catheter, using a lubricant when inserting a catheter, using sterile procedures when inserting a vascular access device, emptying the catheter drainage bag when necessary, and removing catheters and vascular access devices as soon as they are no longer needed.

Professor Leng added: “Although there have been major improvements within the NHS in infection control, particularly in relation to Clostridium difficile and MRSA bloodstream infections in the last few years, healthcare associated infections are still a very real threat to patients, their families and carers and staff. This quality standard gives primary, community and secondary care services the most up-to-date advice on the best ways to minimise the risks of infections.”

Carol Pellowe, Senior lecturer, Guy's & St Thomas' NHS Foundation Trust and member of the committee which developed the standards, said: “This quality standard will promote best practice in infection prevention and control and by providing key areas for action, encourage organisations to sustain their efforts in ensuring patient safety."

Gavin Maxwell, lay member of the committee which developed the standards, said: “This quality standard will help to combat and control the spread of infection, both within health related facilities and across the population at large. As a lay member of the advisory committee, I particularly welcome and support the quality statement relating to responsible prescribing of antibiotics. It will bring substantial benefits.”

Ends

Notes to Editors

References and explanation of terms

1. NHS England (2011) English national point of prevalence survey on healthcare-associated infections and antimicrobial use, 2011: preliminary data
2. National Audit Office (2009) Reducing healthcare associated infections in hospitals in England.
3. A vascular access device is a tube that is inserted into a main vein or artery and used to administer fluids and medication, monitor blood pressure and collect blood samples.
4. Antibiotic resistance, when an infection no longer responds to treatment with one or more types of antibiotics and so is more likely to spread and become serious, poses a significant threat to public health, particularly because antibiotics underpin routine medical practice. Antimicrobial stewardship is an organisational or healthcare-system-wide approach to promoting and monitoring judicious use of antimicrobial drugs to preserve their future effectiveness.

About the quality standard

1. The NICE quality standard for the infection prevention and control is available here.

2. The quality standard is based on: Prevention and control of healthcare-associated infections. NICE public health guidance 36 (2011); Respiratory tract infections - antibiotic prescribing. NICE clinical guideline 69 (2008); Infection: prevention and control of healthcare-associated infections in primary and community care. NICE clinical guideline 139 (2012)

Related NICE quality standards

Published

• Surgical site infection. NICE quality standard 49 (2013).
• Patient experience in adult NHS services. NICE quality standard 15 (2012).
• Service user experience in adult mental health. NICE quality standard 14 (2011).

About NICE quality standards

1. NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

2. NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

3. Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

4. NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

5. NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

6. Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Formerly the National Institute for Health and Clinical Excellence, our name changed on 1 April 2013 to reflect our new and additional responsibility to develop guidance and set quality standards for social care, as outlined in the Health and Social Care Act (2012).

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.