Cost-effectiveness of an Environmental Cleaning Bundle for Reducing Healthcare-associated Infections

Nicole M. White, Adrian G. Barnett, Lisa Hall, Brett G. Mitchell, Alison Farrington, Kate Halton, David L. Paterson, Thomas V. Riley, Anne Gardner, Katie Page, Christian A. Gericke, Nicholas Graves

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: Healthcare-associated infections (HAIs) remain a significant patient safety issue, with point prevalence estimates being ~5% in high-income countries. In 2016-2017, the Researching Effective Approaches to Cleaning in Hospitals (REACH) study implemented an environmental cleaning bundle targeting communication, staff training, improved cleaning technique, product use, and audit of frequent touch-point cleaning. This study evaluates the cost-effectiveness of the environmental cleaning bundle for reducing the incidence of HAIs. METHODS: A stepped-wedge, cluster-randomized trial was conducted in 11 hospitals recruited from 6 Australian states and territories. Bundle effectiveness was measured by the numbers of Staphylococcus aureus bacteremia, Clostridium difficile infection, and vancomycin-resistant enterococci infections prevented in the intervention phase based on estimated reductions in the relative risk of infection. Changes to costs were defined as the cost of implementing the bundle minus cost savings from fewer infections. Health benefits gained from fewer infections were measured in quality-adjusted life-years (QALYs). Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio and net monetary benefit of adopting the cleaning bundle over existing hospital cleaning practices. RESULTS: Implementing the cleaning bundle cost $349 000 Australian dollars (AUD) and generated AUD$147 500 in cost savings. Infections prevented under the cleaning bundle returned a net monetary benefit of AUD$1.02 million and an incremental cost-effectiveness ratio of $4684 per QALY gained. There was an 86% chance that the bundle was cost-effective compared with existing hospital cleaning practices. CONCLUSIONS: A bundled, evidence-based approach to improving hospital cleaning is a cost-effective intervention for reducing the incidence of HAIs.

Original languageEnglish
Pages (from-to)2461-2468
Number of pages8
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume70
Issue number12
DOIs
Publication statusPublished - 10 Jun 2020

Fingerprint Dive into the research topics of 'Cost-effectiveness of an Environmental Cleaning Bundle for Reducing Healthcare-associated Infections'. Together they form a unique fingerprint.

  • Cite this

    White, N. M., Barnett, A. G., Hall, L., Mitchell, B. G., Farrington, A., Halton, K., Paterson, D. L., Riley, T. V., Gardner, A., Page, K., Gericke, C. A., & Graves, N. (2020). Cost-effectiveness of an Environmental Cleaning Bundle for Reducing Healthcare-associated Infections. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 70(12), 2461-2468. https://doi.org/10.1093/cid/ciz717