High Impact Interventions

The HIIs are an evidence-based approach that relate to key clinical procedures or care processes that can reduce the risk of infection if performed appropriately. They have been developed to provide a practical way of highlighting the critical elements of a particular procedure or care process (a care bundle), the key actions required and a means of demonstrating reliability.

The HIIs incorporate care bundles based on best-identified practice and care process and actions associated with quality patient care. Whether they are used in a coronary care unit or a nursing home, the HIIs can also be adapted locally to any healthcare setting as a tool for improvement to help address particular practice or care process issues.

Why should I use an HII?
Patient outcomes can be systematically improved when all elements of the care bundles are performed correctly and consistently.

Organisations that have succeeded in reducing infections have implemented HIIs as part of organisation-wide infection prevention and control strategies and part of robust systems to monitor the effectiveness of clinical processes.

This is a requirement of the The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance (published 14 Dec 2010), which states that registered providers must audit compliance to key policies and procedures for infection prevention.

Regular auditing of the care bundle actions will support cycles of review and continuous improvement in care settings.

How do I use an HII?
To use each HII, you will need to:

  • Print off a copy of the audit sheet
  • Observe the identified clinical procedure
  • Identify on the audit sheet if each of the care actions are undertaken correctly
  • Record the results in a central location
  • Audits of compliance with the care bundle should be carried out regularly. The results should be recorded at the point of care and collected either manually or electronically. Validation of results through peer audit provides further assurance of standardised good clinical practice.

The use of an electronic, graphical package such as the one provided with the HII tool is recommended, as this will increase the understanding and usefulness of the overall results.

The electronic tool will:

  • Collect, collate and produce different views of the information
  • Clearly identify when actions within the care bundle have or have not been performed
  • Provide information to support the development of plans to resolve any issues and improve the quality of care
  • Support a culture of continuous improvement
  • How and when were these HIIs created?

The High Impact Interventions were originally published in 2005 as part of ‘Saving Lives’. Since then, the Department has continued to work with many experts and organisations to ensure the HIIs are built on the most up-to-date evidence.

The current HIIs were re-written in July 2010.

Resources
An introduction to how to create a High Impact Intervention (PDF, 15.7 KB)

An algorithm outlining how to create a High Impact Intervention (PDF, 23.9 KB)

A model demonstrating how to create a High Impact Intervention (PDF, 27.2 KB)

Central venous catheter care (PDF, 66.0 KB)

Central venous catheter high impact intervention – Insertion (XLS, 618.0 KB)

Central venous catheter high impact intervention – Ongoing care (XLS, 615.9 KB)

Peripheral intravenous cannula care (PDF, 50.2 KB)

Peripheral intravenous cannula care high impact intervention – Insertion (XLS, 615.4 KB)

Peripheral intravenous cannula care high impact intervention – Ongoing (XLS, 622.6 KB)

Renal haemodialysis (PDF, 42.4 KB)

Renal haemodialysis high impact intervention – Insertion (XLS, 641.5 KB)

Renal haemodialysis high impact intervention – Ongoing (XLS, 624.1 KB)

Prevention of surgical site infection (PDF, 56.8 KB)

Prevention of surgical site infection high impact intervention – Pre-operative (XLS, 579.1 KB)

Prevention of surgical site infection high impact intervention – Intra-operative (XLS, 615.9 KB)

Prevention of surgical site infection high impact intervention – Post-operative (XLS, 551.9 KB)

Ventilator associated pneumonia (PDF, 52.4 KB)

Ventilator associated pneumonia high impact intervention (XLS, 632.3 KB)

Urinary Catheter Care (PDF, 39.8 KB)

Urinary Catheter Care high impact intervention – Insertion (XLS, 615.9 KB)

Urinary Catheter Care high impact intervention – Ongoing (XLS, 610.8 KB)

Clostridium difficile infection (PDF, 52.1 KB)

Clostridium difficile high impact intervention (XLS, 592.9 KB)

Cleaning and decontamination (PDF, 45.7 KB)

Cleaning and decontamination high impact intervention (XLS, 616.5 KB)

Antimicrobial prescribing – to be added soon

Chronic Wounds (PDF, 49.5 KB)

Chronic wounds high impact intervention – Care actions (XLS, 618.0 KB)

Chronic wounds high impact intervention – Management (XLS, 622.6 KB)

Enteral feeding (PDF, 37.8 KB)

Enteral feeding high impact intervention (XLS, 625.7 KB)

Blood Cultures (PDF, 33.1 KB)

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