This quality improvement guide was produced by NICE, in partnership with the Health Protection Agency (HPA). Its aim is twofold: to reduce the risk of harm from healthcare-associated infections for patients, staff and visitors; and to reduce the costs associated with preventable infection.
This guideline covers prescribing antibiotics in primary care to children (aged 3 months and older), young people and adults with self-limiting respiratory tract infections (RTIs). It provides practical strategies for prescribing, including identifying when immediate antibiotics are needed and when to offer a delayed prescription or reassurance alone. It covers identifying who is at risk of serious illness but not investigations or further care for people needing immediate antibiotics.
This guideline covers detecting and managing metastatic spinal cord compression in adults with cancer that has spread to the spine. It aims to improve quality of life by promoting early detection and management, and reducing spinal cord damage and disability.
This guideline covers recognising and managing borderline personality disorder. It aims to help people with borderline personality disorder to manage feelings of distress, anxiety, worthlessness and anger, and to maintain stable and close relationships with others.
This guideline covers changing health-damaging behaviours among people aged 16 and over using interventions such as goals and planning, feedback and monitoring, and social support. It aims to help tackle a range of behaviours including alcohol misuse, poor eating patterns, lack of physical activity, unsafe sexual behaviour and smoking.
This guideline covers how employers can encourage and support employees to stop smoking. It aims to reduce the number of people who smoke or are exposed to second-hand smoke and the rate of diseases and conditions caused by smoking.
This guideline covers new buildings and communal outdoor areas. The aim is to ensure there are enough shady areas to protect people from overexposure to the sun.
This guideline covers one-to-one interventions to prevent sexually transmitted infections (STIs) and under-18 conceptions. The aim is to reduce the transmission of chlamydia and other STIs, including HIV, and reduce the rate of pregnancies among women aged under 18.
This guideline covers home safety assessments, supplying and installing safety equipment and providing education and advice. It aims to prevent unintentional injuries among all children and young people aged under 15 but, in particular, those living in disadvantaged circumstances.
This guideline covers diagnosing and managing cystic fibrosis. It specifies how to monitor the condition and manage the symptoms to improve quality of life. There are also detailed recommendations on treating the most common infections in people with cystic fibrosis.
This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks. The investment and training required to implement the guideline will take time. In the meantime, primary care services should implement what they can of the recommendations, using currently available approaches to diagnosis until the infrastructure for objective testing is in place.
This guideline covers diagnosing and managing Lyme disease. It aims to raise awareness of when Lyme disease should be suspected and ensure that people have prompt and consistent diagnosis and treatment. It does not cover preventing Lyme disease.
This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.
This guideline covers recognition, assessment and monitoring of faltering growth in infants and children. It includes a definition of growth thresholds for concern and identifying the risk factors for, and possible causes of, faltering growth. It also covers interventions, when to refer, service design, and information and support.
This guideline covers referral and assessment for intermediate care and how to deliver the service. Intermediate care is a multidisciplinary service that helps people to be as independent as possible. It provides support and rehabilitation to people at risk of hospital admission or who have been in hospital. It aims to ensure people transfer from hospital to the community in a timely way and to prevent unnecessary admissions to hospitals and residential care.
This guideline covers diagnosing and managing endometriosis. It aims to raise awareness of the symptoms of endometriosis, and to provide clear advice on what action to take when women with signs and symptoms first present in healthcare settings. It also provides advice on the range of treatments available.
This guideline covers raising awareness of and testing for hepatitis B and C infection. It aims to ensure that people at increased risk of hepatitis B and C infection are tested.
This guideline covers providing brief advice on physical activity to adults in primary care. It aims to improve health and wellbeing by raising awareness of the importance of physical activity and encouraging people to increase or maintain their activity level.
This guideline covers lifestyle weight management services for children and young people aged under 18 who are overweight or obese. It advises how to deliver effective weight management programmes that support children and young people to change their lifestyle and manage their weight.
This guideline covers services for children, young people and adults with a learning disability (or autism and a learning disability) and behaviour that challenges. It aims to promote a lifelong approach to supporting people and their families and carers, focusing on prevention and early intervention and minimising inpatient admissions.
This guideline covers stop smoking interventions and services delivered in primary care and community settings for everyone over the age of 12. It aims to ensure that everyone who smokes is advised and encouraged to stop and given the support they need. It emphasises the importance of targeting vulnerable groups who find smoking cessation hard or who smoke a lot.
This guideline covers recognising, diagnosing and managing attention deficit hyperactivity disorder (ADHD) in children, young people and adults. It aims to improve recognition and diagnosis, as well as the quality of care and support for people with ADHD.
This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.
This guideline covers assessing and managing heavy menstrual bleeding (menorrhagia). It aims to help healthcare professionals investigate the cause of heavy periods that are affecting a woman’s quality of life and to offer the right treatments, taking into account the woman’s priorities and preferences.
This guideline covers organising and delivering emergency and acute medical care for people aged over 16 in the community and in hospital. It aims to reduce the need for hospital admissions by giving advanced training to paramedics and providing community alternatives to hospital care. It also promotes good-quality care in hospital and joint working between health and social services.
This guideline covers how organisations, professionals and carers can work together to deliver high quality care, stable placements and nurturing relationships for looked-after children and young people. It aims to help these children and young people reach their full potential and enjoy the same opportunities in life as their peers.
This guideline covers how to assess and monitor body weight and how to prevent someone from becoming overweight or obese before, during and after pregnancy. The aim is help all women who have a baby to achieve and maintain a healthy weight by adopting a balanced diet and being physically active.
This guideline covers anti-smoking mass-media campaigns, for example, on TV, in newspapers and online. It also covers measures to prevent tobacco being sold to children and young people. The aim is to help prevent children and young people from taking up smoking.
This guideline covers promoting mental wellbeing in people aged over 65. It focuses on practical support for everyday activities, based on occupational therapy principles and methods. This includes working with older people and their carers to agree what kind of support they need.
This guideline covers assessing and managing pelvic fractures, open fractures and severe ankle fractures (known as pilon fractures and intra-articular distal tibia fractures) in pre-hospital settings (including ambulance services), emergency departments and major trauma centres. It aims to reduce deaths and long-term health problems by improving the quality of emergency and urgent care.
This guideline covers approaches to promoting social and emotional wellbeing in children aged 4 to 11 years in primary education. It includes planning and delivering programmes and activities to help children develop social and emotional skills and wellbeing. It also covers identifying signs of anxiety or social and emotional problems in children and how to address them.
This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping families build physical activity into their daily lives.
This guideline covers the risk of early death from heart disease and other smoking-related illnesses. It aims to reduce the number of people who are disadvantaged dying prematurely by ensuring people have better access to flexible, well-coordinated treatment and support.
This guideline covers diagnosing, assessing, managing and monitoring anaemia in people with chronic kidney disease. It aims to improve care for people with chronic kidney disease by specifying how to assess when their anaemia needs treating, and by making detailed recommendations on treatment with erythropoietic stimulating agents (ESAs) and iron. It also covers detecting and managing ESA-resistant anaemia.
This guideline covers diagnosing and managing bronchiolitis in children. It aims to help healthcare professionals diagnose bronchiolitis and identify if children should be cared for at home or in hospital. It describes treatments and interventions that can be used to help with the symptoms of bronchiolitis.
This guideline covers reducing the health risks (including preventable deaths) associated with living in a cold home. It aims to improve the health and wellbeing of people vulnerable to the cold. Improving the temperature in homes, by improving energy efficiency, may also help reduce unnecessary fuel consumption.
This guideline covers managing diabetes and its complications in women who are planning pregnancy or are already pregnant. It aims to improve the diagnosis of gestational diabetes and help women with diabetes to self-manage their blood glucose levels before and during pregnancy.
This guideline covers the clinical care of adults (18 years and over) who are dying during the last 2 to 3 days of life. It aims to improve end of life care for people in their last days of life by communicating respectfully and involving them, and the people important to them, in decisions and by maintaining their comfort and dignity. The guideline covers how to manage common symptoms without causing unacceptable side effects and maintain hydration in the last days of life.
This guideline covers how general dental practice teams can convey advice about oral hygiene and the use of fluoride. It also covers diet, smoking, smokeless tobacco and alcohol intake.
This guideline covers how to communicate the risks and benefits of natural sunlight exposure (specifically, the ultraviolet rays UVA and UVB) to help people understand why they may need to modify their behaviour to reduce their risk of skin cancer and vitamin D deficiency.
This guideline covers the effective use of antimicrobials (including antibiotics) in children, young people and adults. It aims to change prescribing practice to help slow the emergence of antimicrobial resistance and ensure that antimicrobials remain an effective treatment for infection.
This guideline covers how healthcare services for people with sarcoma should be organised. It aims to improve care by recommending which healthcare professionals should be involved and the types of hospital or cancer centre best suited to provide the care.
This guideline covers diagnosing and treating jaundice, which is caused by increased levels of bilirubin in the blood, in newborn babies (neonates). It aims to help detect or prevent very high levels of bilirubin, which can be harmful if not treated.
This guideline covers how healthcare services for people with urological cancer should be organised. It aims to improve care by recommending which healthcare professionals should be involved and the types of hospital or cancer centre best suited to provide the care.
This guideline covers how healthcare services for colorectal cancer should be organised. It aims to improve care for people with colorectal cancer by recommending which healthcare professionals should be involved in care.
This guideline covers interventions and support for children, young people and adults with a learning disability and behaviour that challenges. It highlights the importance of understanding the cause of behaviour that challenges, and performing thorough assessments so that steps can be taken to help people change their behaviour and improve their quality of life. The guideline also covers support and intervention for family members or carers.
This guideline covers interventions to maintain and improve the mental wellbeing and independence of people aged 65 or older and how to identify those most at risk of a decline.
This guideline covers the diagnosing and managing of myeloma (including smouldering myeloma and primary plasma cell leukaemia) in people aged 16 and over. It aims to improve care for people with myeloma by promoting the most effective tests and treatments for myeloma and its complications.
This guideline covers assessing and managing cancers of the upper aerodigestive tract in people aged 16 and over. These are cancers of the airways of the head and neck, including the mouth, throat, larynx (voicebox) and sinuses. It aims to reduce variation in practice and improve survival.
This guideline covers the assessment and early management of spinal column and spinal cord injury in pre-hospital settings (including ambulance services), emergency departments and major trauma centres. It covers traumatic injuries to the spine but does not cover spinal injury caused by a disease.It aims to reduce death and disability by improving the quality of emergency and urgent care.