Healthcare-associated infections: prevention and control

Reasons for the decision

PH36 is a quality improvement guide produced by NICE, in partnership with the Health Protection Agency (HPA). The guide includes quality improvement statements (QIS) on prevention and control of healthcare-associated infections (HCAI) aiming to improve the quality of care and practice over and above current standards as set out in the Department of Health's the Health and Social Care Act 2008.

Since PH36 was developed, Public Health England and the Department of Health and Social Care have published more recent policy documents covering the prevention and control of HCAI. Additionally, the Health and Social Care Act 2008 covers a code of practice for infection prevention and control and NHS Improvement has produced more recent EPIC 3 guidelines for preventing HCAI (2017).

In light of the additional policy and guidance in this area, we investigated whether the QIS within PH36 have been superseded by alternative, existing documents. The aim of the surveillance review was to determine whether the content within PH36 had been sufficiently covered elsewhere and therefore could be stood down. Topic experts completed a questionnaire with a focus as to whether or not quality improvement guide PH36 should be stood down. Topic experts felt that the guide should be retained as it was a concise source of information for HCAI. A mapping exercise (see appendix A: summary of evidence from surveillance) confirmed this, highlighting that PH36 had some unique content compared with other guidance, policy and legislation.

Stakeholder feedback suggested that PH36 should include a detailed definition of what effective hand hygiene auditing is. However, we didn't identify any evidence through this surveillance review to indicate what would be the most effective method of hand hygiene auditing and other policy or legislative documents include detail on hand hygiene auditing, therefore we do not feel an update of PH36 in this area is warranted.

Overall, we have decided not to update PH36 as no evidence or intelligence was identified through the surveillance review to indicate the QIS are out of date. There are a number of other relevant products covering the prevention and control of HCAI. A mapping exercise conducted as part of the surveillance review indicated that PH36 had some unique content compared with other available guidance, policy and legislation. Therefore, we feel there is value to the system in retaining this quality improvement guide.

For further details and a summary of the surveillance mapping exercise, see appendix A.