NICE (National Institute for Health and Care Excellence) check their guidelines regularly to ensure they remain up to date. They have decided not to update the guideline on antimicrobial stewardship at this time. NICE based the decision on surveillance 2 years after the publication of NICE’s guideline on antimicrobial stewardship (NICE guideline NG15) in 2015.
Reason for the decision
Assessing the evidence
For this guideline, NICE checked any policy or other guidance documents that had been issued or updated since NICE guideline NG15 was published. They also checked any Cochrane reviews related to the guideline – this included any updates to the 4 Cochrane reviews used to inform the recommendations during development of the guideline, as well as any new Cochrane reviews published since October 2014 when the original search took place. In addition, NICE also checked for any relevant National Institute for Health Research (NIHR) Signals. Each piece of evidence was checked against the guideline recommendations to assess any potential impact.
The policy, Cochrane reviews and NIHR Signals NICE examined did not indicate a need to update the guideline, therefore we did not undertake a formal evidence review. Furthermore, members of the original guideline committee were in agreement that there had been no substantial changes to the evidence base that would affect the guideline at this point .
NICE also checked for any relevant ongoing studies, and the impact of any publications arising from these in future will be monitored.
After considering the evidence described above as well as the views of topic experts and stakeholders, NICE proposes to not update this guideline.
The UK AMR strategy represents an ambitious programme to slow the development and spread of AMR, taking a ‘One Health’ approach spanning people, animals, agriculture and the wider environment.
The report sets out progress made in 2016, and notes that for the remaining 2 years of the strategy, the programme will focus on delivery of the government’s ambitions set out in response to the review on AMR led by Lord O’Neill. These include ambitions to halve certain types of infection and the inappropriate use of antibiotics.
This professional resource outlines the importance of infection prevention and control and how it can contribute to reducing antimicrobial resistance (AMR) | Public Health England
Every infection prevented reduces the need for and use of antimicrobials, which in turn lessens the potential for development of resistance. In the UK, the current rising threat from drug resistant organisms is from Gram-negative bacteria. Infections caused by Gram-negative organisms are increasing. This professional resource outlines the importance of infection prevention and control and how it can contribute to reducing antimicrobial resistance.
NHS staff who refuse to have the flu vaccine this winter will have to give reasons to their employer, as leaders make efforts to improve take-up rates| BMJ2017; 359
NHS leaders are to write to all NHS staff urging them to be vaccinated against flu as soon as possible. The letter will make it clear that staff who refuse the vaccine will have to give reasons to their employing NHS trust, which will then be recorded.
The heads of NHS England, Public Health England, the Department of Health for England, and NHS Improvement said that they were writing to remind staff of their “professional duty to protect their patients.” Trusts are also being urged to make the flu vaccine “readily available” to staff.
Although last year saw record take-up of the vaccine among staff, more than a third of NHS staff members did not take up the offer, with just a fifth being vaccinated in some trusts.
Hospitals and GP surgeries are being warned by NHS England to be prepared for a big increase in cases of flu this winter after a heavy season in the southern hemisphere.
This quality standard covers interventions to improve the uptake of HIV testing among people who may have undiagnosed HIV. It focuses on increasing testing to reduce undiagnosed infection in people at increased risk of exposure. It describes high-quality care in priority areas for improvement.
This issue of Health Matters focuses on making cervical screening more accessible.
This latest edition of Health Matters aims to address the decline in cervical screening attendance by presenting recommendations that can help increase access to screening and awareness of cervical cancer.
Despite the success of the programme, screening coverage has fallen over the last 10 years and attendance is now at a 19-year low. Coverage is going down across all age groups.
Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36) | The Royal College of Obstetricians and Gynaecologists.
Group B Streptococcal Disease (GBS) is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.
In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.
The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families.
Nosocomial infections place a heavy burden on the healthcare system. However, quantifying the burden raises many questions, ranging from the way to accurately estimate the extra length of stay at hospital to defining and costing the preventative methods among the different care providers | Journal of Hospital Infection
A total of 52 episodes were screened during the study period. The estimated mean cost of CDI was approximately €23,909 (SD = 17,458) for an extended length of hospital stay (N = 27). In the case of a reduced length of the hospital stay (N = 25), the mean cost was approximately € –14,697 (SD = 16,936), which represents net savings for the hospitals. The main cost/savings driver was the productivity losses/gains resulting from the nosocomial infection. A sensitivity analysis showed that the main factor explaining the amount of costs or savings due to nosocomial infections was the length of the hospital stay.
Conclusion: We discuss the notion of productivity gains in the case of deaths as a factor revealing the incompleteness of the payment systems. We then discuss the methodological issues associated with the statistical method used to control for temporality bias.