Areas for further research
These guidelines have been developed from the best evidence currently available. However, there is always scope for improving the evidence base and during the development of these guidelines several areas for potential further research have been highlighted, some of which are highlighted below.
Adherence / behaviour change
Action research studies to explore the use of behavioural and quality management sciences to improve adherence of healthcare professionals to infection prevention guidelines, specifically in relation to:
- Hand hygiene;
- The effect of different products, for example, gels, foams and lotions on improving adherence to recommended hand hygiene regimens;
- Standard principles for the prevention of the transmission of bloodborne pathogens;
- Cleanliness of the hospital environment.
- Trials of the effectiveness of different educational methods to increase adherence to guidelines.
- Development and evaluation of appropriate strategies for auditing adherence to infection prevention guidelines.
- Investigate the relationship between healthcare workers' staffing levels, workload and skill mix and risk for nosocomial infections.
- Develop appropriate and realistic methods and tools to facilitate local surveillance of hospital-acquired infections.
- The role of screening for HCAI organisms as a means of controlling
- Further research on community MRSA colonisation and its impact on acute care.
Needle safety devices
- Studies to establish the cost-effectiveness, acceptability and efficacy of needle safety devices.
- Studies to link improvement in infection control practice, patient outcome and cultural change;
- Studies to assess performance monitoring of mandatory infection control standards linked to government improvement practice
- The role of inter ward and inter hospital transfers on spread of HCAI
Key audit criteria
Apart form providing practice advice, guidelines can also be used as audit criteria to measure adherence. Below are some examples of how these guidelines can be used.
To ensure all healthcare workers have access to appropriate hand decontamination equipment and protective clothing whenever they deliver care
All healthcare areas should have an appropriate supply of hand decontamination equipment, gloves, aprons and protective clothing in their care setting.
Data collection: self audit*
Ensure that all healthcare workers are trained and competent in hand decontamination and risk assessment.
All healthcare workers involved in care are trained and updated in hand decontamination.
Data collection: review of staff education records
To ensure that all healthcare workers respond appropriately to any sharps injury
All healthcare workers should be aware of their local sharps injury policy and how to access appropriate help should they sustain a sharps injury.
Data collection: direct questioning
*The Department of Health (2006). Self assessment tools: The delivery programme to reduce Healthcare associated infections including MRSA:Essential steps to safe, clean care.. Available from www.dh.gov.uk Saving Lives Delivery Programme
Other useful audit criteria is available at www.nhsggc.org.uk/icmanual
The complete set of the epic2 guidelines are available from www.richardwellsresearch.com