Where is the strength of evidence? A review of infection prevention and control guidelines

Journal article


Mitchell, B. G., Fasugba, O. and Russo, P. L.. (2020). Where is the strength of evidence? A review of infection prevention and control guidelines. Journal of Hospital Infection. 105(2), pp. 242-251. https://doi.org/10.1016/j.jhin.2020.01.008
AuthorsMitchell, B. G., Fasugba, O. and Russo, P. L.
Abstract

An important aspect of safety and quality in healthcare is the implementation of infection prevention and control guidelines. However, little is known regarding the strength of evidence on which recommendations for such guidelines are based. This study aimed to describe the strength of recommendations of infection prevention and control guidelines published in the last 10 years. For this review, the websites of government and professional organizations for national and international infection prevention and control clinical guidelines were purposively searched. The search was limited to publications between January 2009 and April 2019, and those with a formal grading system were used to determine the strength of the evidence underpinning the recommendations. Recommendations from guidelines were categorized into 21 infection control categories. A descriptive synthesis of the data was undertaken.

A total of 31 guidelines comprising 1855 recommendations were included. Guidelines were mainly developed in the USA (N = 11, 35.5%) and Canada (N = 9, 29.0%). Most guidelines used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach (N = 6, 19.4%. The majority of the guidelines contained recommendations categorized under the themes of devices (N = 316, 16.9%) and transmission-based precautions (N = 315, 16.8%). Most recommendations (N = 769, 41.5%) were graded as using evidence from descriptive studies, expert opinion and low-quality evidence.

There are a vast number of infection prevention and control guidelines developed by national and international government or professional organizations, many without a strong evidence base. This presents multiple research opportunities that should prioritize common prevention activities that currently have a low evidence base.

Keywordsinfection control; standards; evidence-based practice; evidence-based medicine
Year2020
JournalJournal of Hospital Infection
Journal citation105 (2), pp. 242-251
PublisherElsevier Ltd
ISSN0195-6701
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jhin.2020.01.008
Scopus EID2-s2.0-85078967660
Research or scholarlyResearch
Page range242-251
FunderNational Health and Medical Research Council
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online21 Jan 2020
Publication process dates
Accepted08 Jan 2020
Deposited24 Aug 2021
Grant IDNHMRC/1156312
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