The National Clinical Effectiveness Committee (NCEC) requires consideration of evidence on the clinical and cost-effectiveness of guideline recommendations in the development of all National Clinical Guidelines (NCGs) in Ireland. The completion of a budget impact analysis (BIA) based on implementation of the NCG is also required. The role of the HRB-CICER team is to independently review evidence and provide scientific and methodological support in the development, by the Guideline Development Group (GDG), of these evidence-based NCGs.

The NCG for Infection Prevention Control (IPC) has been developed to assist health and social care workers in the creation of clean and safe healthcare environments through the implementation of evidence-based practices that minimise the risk of transmission of infectious microorganisms.

To support the development of the NCG, the HRB-CICER team conducted the following:

• a systematic review of the clinical and cost effectiveness of interventions to improve adherence to hand hygiene recommendations in healthcare settings
• a systematic review of the clinical and cost effectiveness of the use of all single patient room (SPR) accommodation (compared with use of multi-bed rooms or mixed single rooms and multi-bed room accommodation) in reducing the incidence of healthcare-associated infections in general acute settings
• a BIA to quantify the cost and resource implications to the Health Service Executive, following implementation of the NCG. 
  
   

Healthcare-associated infections (HCAIs) are infections that can develop after contact with healthcare services. Many HCAIs are preventable and a healthcare system has a duty to prevent HCAIs to the greatest practical extent. This NCG provides recommendations to support those working in health and social settings in providing safe, high-quality care for those who use these services, as well as a safe working environment for those that work in these settings.

The aim of the first systematic review undertaken by HRB-CICER was to evaluate interventions aimed at improving hand hygiene adherence in health care workers. The aim of the second systematic review was to evaluate whether single patient room (SPR) accommodation is effective in reducing HCAI rates compared with accommodation consisting of multi-bed rooms or mixed single rooms and multi-bed rooms. This review found a lack of evidence to determine the net benefit or risk of SPRs as an intervention to reduce HCAI. Additionally, no cost-effectiveness studies were identified. 

The budget impact analysis aimed to quantify the cost and resource implications, of implementing the guideline recommendations. Based on the NCG recommendations and implementation plan, the main resource implications comprise:

• the development and delivery of E-learning modules to provide information on, and support adherence to, the recommendations outlined in the guideline. 
• the development and delivery of webinars to provide information on, and support adherence to, the recommendations outlined in the guideline. 
  
   

The systematic reviews adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria.ǂ

The Budget Impact Analysis was conducted in accordance with the HIQA guidelines for budget impact analysis and economic evaluation in Ireland. 

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ǂ Available at PRISMA