Healthcare-associated infections: prevention and control in primary and community care – NICE guideline

Clinical context

Patient safety has become a cornerstone of care, and preventing healthcare-associated infections remains a priority. It is estimated that 300,000 patients a year in England acquire a healthcare-associated infection as a result of care within the NHS. In 2007, meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile infections were recorded as the underlying cause of, or a contributory factor in, approximately 9,000 deaths in hospital and primary care in England.

Healthcare-associated infections are estimated to cost the NHS approximately £1 billion a year, and £56 million of this is estimated to be incurred after patients are discharged from hospital. In addition to increased costs, each one of these infections means additional use of NHS resources, greater patient discomfort and a decrease in patient safety. A no-tolerance attitude is now prevalent in relation to avoidable healthcare-associated infections.

Audience

The population covered in this guideline is all adults and children receiving healthcare for which standard infection-control precautions apply in primary care and community care. This guideline is commissioned by the NHS, but people providing healthcare in other settings, such as private settings, may also find the guidance relevant.

This guideline applies to all healthcare workers employed in primary and community care settings, including ambulance services, and should ensure safe practice if applied consistently. Much care is also delivered by informal carers and family members, and this guideline is equally applicable to them.

Rationale for the update

Since the publication of the NICE clinical guideline on the prevention of healthcare-associated infection in primary and community care in 2003, many changes have occurred within the NHS that place the patient firmly at the centre of all activities. First, the NHS Constitution for England defines the rights and pledges that every patient can expect regarding their care. To support this, the Care Quality Commission (CQC), the independent regulator of all health and adult social care in England, ensures that health and social care is safe, and monitors how providers comply with established standards. In addition, the legal framework that underpins the guidance has changed since 2003.

New guidance is needed to reflect the fact that, as a result of the rapid turnover of patients in acute care settings, complex care is increasingly being delivered in the community. New standards for the care of patients and the management of devices to prevent related healthcare-associated infections are needed that will also reinforce the principles of asepsis.

You can read the guideline on NICE's website.

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