An Economic Analysis of Adherence Engineering to Improve Use of Best Practices During Central Line Maintenance Procedures

Abstract

An adherence engineering-based intervention to streamline the CLM process can improve patient outcomes and lower costs. Patient safety can be improved by adopting new approaches that are based on human factors principles.

Economic Evaluation of Quality Improvement Interventions for Bloodstream Infections Related to Central Catheters

“…Searches of gray literature did not identify eligible articles. Fifteen excluded studies tested materials or equipment but omitted costs associated with implementation . See Figure 1 for PRISMA diagram.…”

“…The 15 studies excluded because they omitted implementation costs examined maximum sterile barriers; antibiotic-impregnated CVCs; antimicrobial dressings, 1-piece vs 2-piece chlorhexidine-gluconate-impregnated dressings, chlorhexidine gluconate vs providone-iodine solutions for insertion site care, standardized maintenance kits vs ad hoc supplies, and disinfection caps for CVC hubs vs scrubbing the hubs …”

“…Fifteen excluded studies tested materials or equipment but omitted costs associated with implementation. 15,[43][44][45][46][47][48][49][50][51][52][53][54][55][56] See Figure 1 for PRISMA diagram.…”

“…Investigators compared interventions involving checklists vs usual care in 7 studies, 28,29,32,36,[38][39][40][41] other practices vs usual care in 3 studies 31,33,35 (although in 1, the usual care scenario included 2 common components of checklists), 35 and other practices vs usual care with checklists already in use in 5 studies. 27,30,34,37,42 The 15 studies excluded because they omitted implementation costs examined maximum sterile barriers 47 ; antibioticimpregnated CVCs 45,46,49,51,52 ; antimicrobial dressings, 15,44,48,53 1-piece vs 2-piece chlorhexidine-gluconate-impregnated dressings, 43 chlorhexidine gluconate vs providone-iodine solutions for insertion site care, 49 standardized maintenance kits vs ad hoc supplies, 54 and disinfection caps for CVC hubs vs scrubbing the hubs. 55,56 Context Thirteen of the 15 unique studies (Table 2) were based in the US, [27][28][29][30][31]33,[35][36][37][38][39][40][41][42] 1 in the United Kingdom, 32 and 1 in Ireland.…”