epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England R.J. Pratt a *, C.M. Pellowe a , J.A. Wilson a,b , H.P. Loveday a , P.J. Harper a , S.R.L.J. Jones a , C. McDougall b , M.H. Wilcox c a Richard Wells Research Centre, Faculty of Health and Human Sciences, Thames Valley University (London). b Department of Healthcare Associated Infection and Antimicrobial Resistance, Centre for Infections, Health Protection Agency (London). c Microbiology and Infection Control, Leeds Teaching Hospitals NHS Trust and University of Leeds. Submitted 23 November 2006 Available online 5 February 2007 Executive Summary National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were commissioned by the Department of Health (DH) and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were published in January 2001. 1 These guidelines describe the precautions healthcare workers should take in three areas: standard principles for preventing HCAI, which include hospital environmental hygiene, hand hygiene, the use of personal protective equipment, and the safe use and disposal of sharps; preventing infections associated with the use of short-term indwelling urethral catheters; and preventing infections associated with central venous catheters. The evidence for these guidelines was identified by multiple systematic reviews of experimental and non- experimental research and expert opinion as reflected in systematically identified professional, national and international guidelines, which were formally assessed by a validated appraisal process. In 2003, we developed complementary national guidelines for preventing HCAI in primary and community care on behalf of the National Collaborating Centre for Nursing and Supportive Care (National Institute for Health and Clinical Excellence). 2 A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective in preventing HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. Consequently, the DH commissioned a review of new evidence published following the last systematic reviews. We have now updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the original epic guidelines published in 2001 remain robust, relevant and appropriate but that adjustments need to be *Corresponding author: Professor Robert J. Pratt, Director, Richard Wells Research Centre, Faculty of Health and Human Sciences, Thames Valley University, 32-38 Uxbridge Road, London W5 2BS. Telephone: +44 (0)20 8280 5142; email: robert.pratt@tvu.ac.uk Journal of Hospital Infection (2007) 65S, S1–S64 Available online at www.sciencedirect.com www.elsevierhealth.com/journals/jhin