The National Institute for Health and Clinical Excellence has, for the first time, published two pieces of draft guidance on cost-effective interventions designed to improve the safety of patients using the National Health Service.

Working with the National Patient Safety Agency, NICE has made recommendations regarding the prevention of pneumonia in mechanically ventilated patients and streamlining processes to ensure that any drugs patients are taking before they go to hospital is properly documented on admission.

“This is the first time NICE has developed guidance on safety issues within the NHS,” said Andrew Dillon, Chief Executive of NICE. “Ventilator-associated pneumonia and ineffective medicines reconciliation at hospital admission are significant causes of patient morbidity and mortality and therefore present important safety concerns that need to be addressed,” he added.

'Top priority'

And commenting on the move, Dr Helen Glenister, Deputy Chief Executive of the NPSA, stressed that patient safety should be “the top priority” for everyone working in healthcare, and said of the collaboration between the two groups: “It’s an excellent opportunity for our two organisations to share our expertise and learn from each other for the benefit of frontline staff – and ultimately patients. We are building on our existing work in developing safety solutions and sharing this knowledge with NICE to reduce risk to patients in these two diverse areas.”

Specifically, for the prevention of ventilator-associated pneumonia the Institute recommends that patients should be positioned with their upper body elevated for as much of the time as possible, although it concedes that this will not be possible in some cases. In addition, it says that oral antiseptics, such as chlorhexidine, should be given to patients who are intubated and receiving mechanical ventilation.

With regard to improving the documentation of a patient’s prior medication on admission to hospital, NICE’s provisional guidance states that all appropriate departments should put in place a policy for improving medicines reconciliation, to ensure that: a pharmacist is involved as soon as possible after admission; the responsibilities of pharmacists and other staff in medicines reconciliation are clearly defined; and the incorporation of strategies to help patients with communication difficulties give full details of their medication.

The draft guidance is available for public consultation on the NICE website until October 10, and Dillon says the Institute is “keen to hear feedback on these draft recommendations and would urge people to send us their comments.” Final guidance is expected in December.