Changes in Healthcare-Associated <i>Staphylococcus aureus</i> Bloodstream Infections after the Introduction of a National Hand Hygiene Initiative

Barnett, Adrian; Page, Katie; Campbell, Megan; Martín, Elizabeth; Rashleigh-Rolls, Rebecca; Halton, Kate; Hall, Lisa; Jimmieson, Nerina L.; White, Katherine M.; Paterson, David L.; Graves, Nicholas

doi:10.1086/677160

Cited by 16 publications

(12 citation statements)

References 21 publications

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“…Given the high number of enrolled wards not performing HAI surveillance, implementing infection surveillance to evaluate the impact of the campaign on patient outcomes for the duration of the study or using available surveillance data from a proportion of wards only was considered unfeasible and potentially inaccurate. However, a large number of other studies have explored the link between hand hygiene and infection rates [1] and investigators continue to add positive evidence [27-30]. …”

Section: Discussionmentioning

confidence: 99%

Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

et al. 2017

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A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.

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Section: Discussionmentioning

confidence: 99%

Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

et al. 2017

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“…Die Hände des Personals werden bei Maßnahmen am Patienten sowie bei Kontakt mit der unmittelbaren Patientenumgebung mit potentiell pathogenen Erregern kontaminiert [24][25][26][27][28][29][30] [95][96][97][98][99][100][101][102]. Ebenso ist die Effizienz der Hände-desinfektion bei der Beherrschung von Ausbrüchen nachgewiesen [103][104][105][106].…”

Section: Die Hygienische Händedesinfektionunclassified

Händehygiene in Einrichtungen des Gesundheitswesens

2016

Bundesgesundheitsbl

173

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“…Reductions in risk of Staphylococcus aureus bacteraemia from the introduction of the national initiative were estimated using 2,304 monthly infection rates across 38 hospitals in six states and territories. A brief summary is provided and a complete description of the statistical method and results are available [ 35 ]. There was variability in the start date among sites, Appendix C in S1 File .…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

et al. 2016

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BackgroundThe objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.MethodsThe design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012.FindingsNo useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.ConclusionsThe Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of $42,000 per life year gained. The return on investment varied among the states and territories of Australia.

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Changes in Healthcare-Associated Staphylococcus aureus Bloodstream Infections after the Introduction of a National Hand Hygiene Initiative

Cited by 16 publications

References 21 publications

Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

Händehygiene in Einrichtungen des Gesundheitswesens

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

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