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ChapterReview questionsOutcomes
Standard principlesWhat information do healthcare professionals, patients and carers require to prevent healthcare-associated infections in primary and community care settings?Information and evidence about what type of information should be provided to patients regarding hand decontamination to prevent healthcare-associated infections.
Hand decontaminationWhat is the clinical and cost effectiveness of when to decontaminate hands, including after the removal of gloves, on hand decontamination compliance, MRSA and C. diff reduction or cross infection, colony forming units and removal of physical contamination?Colony forming units, hand decontamination compliance, MRSA and C. diff reduction and cross infection and removal of physical contamination.
Hand decontaminationWhat is the clinical and cost effectiveness of cleaning preparations (soap and water, alcohol based rubs, non-alcohol products and wipes) for healthcare worker hand decontamination, on hand decontamination compliance, MRSA and C. diff reduction or cross infection, colony forming units and removal of physical contamination?Colony forming units, hand decontamination compliance, MRSA and C. diff reduction and cross infection and removal of physical contamination.
Hand decontaminationWhat is the clinical and cost effectiveness of healthcare workers decontaminating wrists vs. not decontaminating wrists or usual practice on MRSA and C. diff reduction or cross infection, colony forming units and removal of physical contamination and transient organisms?Colony forming units, hand decontamination compliance, MRSA and C. diff reduction and cross infection and removal of physical contamination and transient organisms.
Hand decontaminationWhat is the clinical and cost effectiveness of healthcare workers following bare below the elbow policies (short sleeves or rolled up sleeves) vs. no bare below the elbow policy (long sleeves, not rolled up or no specific restrictions) on MRSA and C. diff reduction or cross infection, colony forming units and removal of physical contamination and transient organisms?Colony forming units, hand decontamination compliance, MRSA and C. diff reduction and cross infection and removal of physical contamination and transient organisms.
Personal protective equipmentWhat is the clinical and cost effectiveness of healthcare workers wearing vinyl, latex or nitrile gloves on user preference and reduction of hypersensitivity, blood borne infections, glove porosity and tears?Ability to perform task, blood borne infections, bodily fluid contamination, glove porosity, holes or tears, hypersensitivity and user preference.
Personal protective equipmentWhat is the clinical and cost effectiveness of healthcare workers wearing plastic aprons or fluid repellent gowns vs. no aprons or gowns, gloves only or standard uniform on the reduction of blood and bodily fluid and pathogenic microorganism contamination?Blood borne viruses and bodily fluid contamination.
SharpsWhat is the clinical and cost effectiveness of healthcare workers using safety needle cannulae vs. standard cannulae on compliance and user preference, infection related mortality and morbidity and sharps injuries?Blood borne infection, compliance, infection related mortality and morbidity, sharps injuries and user preference.
SharpsWhat is the clinical and cost effectiveness of healthcare workers using safety needle devices (needle free, retractable needles, safety resheathing devices) vs. standard needles on compliance and user preference, infection related mortality and morbidity and sharps injuries?Blood borne infection, compliance, infection related mortality and morbidity, sharps injuries and user preference.
Waste DisposalAre there any changes in the legislations which affect the disposal of personal protective equipments in relation to patient care in the primary and community care settings?Updated based on legislation.
Waste DisposalAre there any changes in the legislations which affect the disposal of sharp instruments and needles in relation to patient care in the primary and community care settings?Updated based on legislation.
Long-term urinary cathetersWhat is the clinical and cost effectiveness of different types of long-term indwelling urinary catheters (non-coated silicone, hydrophilic coated, or silver or antimicrobial coated/impregnated) on urinary tract infections, bacteraemia, frequency of catheter change, encrustations and blockages, mortality, and patient preference?Symptomatic UTIs, bacteraemia, frequency of catheter change, encrustations and blockages, mortality, patient preference and comfort.
Long-term urinary cathetersWhat is the clinical and cost effectiveness of different types of long-term intermittent urinary catheters (non-coated, hydrophilic or gel reservoir) on symptomatic urinary tract infections, bacteraemia, mortality, and patient preference?Symptomatic UTIs, bacteraemia, mortality, patient preference and comfort.
Long-term urinary cathetersIn patients performing intermittent catheterisation, what is the clinical and cost effectiveness of non-coated catheters reused multiple times compared to single-use on urinary tract infections, bacteraemia, mortality, and patient preference?Symptomatic UTIs, bacteraemia, mortality, patient preference and comfort.
Long-term urinary cathetersWhat is the clinical and cost effectiveness of bladder instillations or washouts on reduction of catheter associated symptomatic urinary tract infections and encrustations and blockages?Symptomatic UTIs, bacteraemia, frequency of catheter change, encrustations and blockages, mortality, patient preference and comfort.
Long-term urinary cathetersIn patients with long-term urinary catheters (more than 28 days), what is the clinical and cost effectiveness of prophylactic antibiotics (single dose or short course) use during catheter change on reduction of urinary tract infections?Antibiotic resistance, bacteraemia, mortality, patient preference, symptomatic UTIs, upper UTIs.
Enteral feedingWhat is the clinical and cost effectiveness of single vs. reusable syringes used to flush percutaneous endoscopic gastrostomy (PEG) tubes on reduction of tube blockages, diarrhoea, fungal colonisation, gastrostomy site infection, peritonitis and vomiting?Blockages or tube occlusion, diarrhoea, vomiting, fungal colonisation, gastrostomy site infection and peritonitis.
Vascular access devicesWhat is the most clinical and cost effective product or solution for decontamination of the skin prior to insertion of peripherally inserted VAD on catheter tip colonisation, infection related mortality, frequency of line removal, septicaemia, bacteraemia and phlebitis?Catheter tip colonisation, infection related mortality, septicaemia, VAD line removal, VAD related bacteraemia, VAD related phlebitis and VAD related soft tissue infection.
Vascular access devicesWhat is the clinical and cost effectiveness of dressings (transparent semipermeable, impregnated or gauze and tape) covering peripherally or centrally inserted vascular access device insertion sites, including those that are bleeding or oozing, on catheter tip colonisation, frequency of dressing change, infection related mortality, septicaemia, bacteraemia and phlebitis?Catheter tip colonisation, frequency of dressing change, infection related mortality, septicaemia, VAD related bacteraemia and VAD related phlebitis.
Vascular access devicesWhat is the clinical and cost effectiveness of frequency of dressing change (from daily up to 7 days) on catheter tip colonisation, frequency of dressing change, infection related mortality, septicaemia, bacteraemia and phlebitis?Catheter tip colonisation, frequency of dressing change, infection related mortality, septicaemia, VAD related bacteraemia, VAD related phlebitis.
Vascular access devicesWhat is the most clinical and cost effective product or solution for skin decontamination when changing VAD dressings on catheter tip colonisation, infection related mortality, frequency of line removal, septicaemia, bacteraemia and phlebitis?Catheter tip colonisation, infection related mortality, septicaemia, VAD line removal, VAD related bacteraemia, VAD related phlebitis and VAD related soft tissue infection.
Vascular access devicesWhat is the most clinical and cost effective duration of application of decontamination product/solution to the skin prior to insertion of peripherally inserted VAD on catheter tip colonisation, infection related mortality, frequency of line removal, septicaemia, bacteraemia and phlebitis?Catheter tip colonisation, infection related mortality, septicaemia, VAD line removal, VAD related bacteraemia, VAD related phlebitis and VAD related soft tissue infection.
Vascular access devicesWhat is the most clinical and cost effective product or solution for decontaminating VAD ports and hubs prior to access on catheter tip colonisation, infection related mortality, septicaemia, bacteraemia and frequency of line removal?Catheter tip colonisation, infection related mortality, septicaemia, VAD line removal, VAD related bacteraemia, VAD related phlebitis and VAD related soft tissue infection.
Vascular access devicesWhat is the clinical and cost effectiveness of multi dose vials vs. single-use vials for administrating infusions or drugs on preventing contamination of the infusate and healthcare-associated infection?Catheter tip colonisation, infection related mortality, septicaemia, VAD line removal, VAD related bacteraemia, VAD related phlebitis and VAD related soft tissue infection.
Asepsis (Long-term urinary catheters)What is the most clinically and cost effective technique (such as aseptic technique, non-touch technique, aseptic non-touch technique or a clean technique) when handling long-term urinary catheters to reduce colony forming units, urinary tract infections, compliance, MRSA or C. diff reduction and mortality?UTIs, infection related mortality, septicaemia, bacteraemia, phlebitis, compliance and MRSA or C. diff reduction.
Asepsis (Enteral feeding)What is the most clinically and cost effective technique (such as aseptic technique, non-touch technique, aseptic non-touch technique or a clean technique) when handling PEGs to reduce healthcare-associated infections?Infection related bacteraemia, infection related mortality, compliance and MRSA or C. diff reduction.
Asepsis (Vascular access devices)What is the most clinically and cost effective technique (such as aseptic technique, non-touch technique, aseptic non-touch technique or a clean technique) when handling vascular access devices to reduce infection related bacteraemia, phlebitis, compliance, MRSA or C. diff reduction and mortality?Catheter tip colonisation, Infection related mortality, septicaemia, VAD related bacteraemia, VAD related phlebitis, compliance and MRSA or C. diff reduction.

From: 3, Methods

Cover of Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care
Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2.
NICE Clinical Guidelines, No. 139.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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