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

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

doi:10.1093/cid/ciz717

Cited by 27 publications

(31 citation statements)

References 35 publications

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“…It is well accepted that the clinical environment plays a role in the transmission of infections such as multi-drug resistant organisms (MDROs) and healthcare associated infections (HCAIs) [ 2 , 7 , 8 , 12 , 14 , 15 , [17] , [18] , [19] , [20] ]. Ineffective cleaning practices by nursing and midwifery staff may also contribute to a high pathogen-load being present within hospital settings [ 15 , 19 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, there is a higher risk of a patient acquiring a pathogen from the previous room occupant [15,16]. Improved cleaning can reduce the incidence of HCAIs and is cost effective [12,17], but relies on healthcare personnel to correctly and consistently apply cleaning measures. Nurses and midwives have the most contact with patients across healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

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Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Mitchell

Russo

Kiernan

et al. 2021

Infection, Disease & Health

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Background: As frontline providers of care, nurses and midwives play a critical role in controlling infections such as COVID-19, influenza, multi-drug resistant organisms and health care associated infections. Improved cleaning can reduce the incidence of infection and is cost effective but relies on healthcare personnel to correctly apply cleaning measures. As nurses and midwives have the most contact with patients and as an important first step in improving compliance, this study sought to explore nurses' and midwives' knowledge on the role of the environment in infection prevention and control and identify challenges in maintaining clean patient environments. Methods: Cross-sectional online survey of 96 nurses (RN/EN) and midwives (RW) employed in clinical settings (e.g. hospital, aged care, medical centre, clinic) in Australia. Results: Nurses and midwives broadly stated that they understood the importance of cleaning. However, cleaning responsibilities varied and there was confusion regarding the application of different disinfectants when cleaning after patients with a suspected or diagnosed infection post-discharge. Most would not be confident being placed in a room where a previous patient had a diagnosed infection such as multi-drug resistant organism. Conclusion: Greater organisational support and improving applied knowledge about infection control procedures is needed. This includes correct use of disinfectants, which disinfectant to use for various situations, and cleaning effectively following discharge of a patient with known infection. The cleanliness of shared medical equipment may also pose current risk due to lack of cleaning.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Mitchell

Russo

Kiernan

et al. 2021

Infection, Disease & Health

View full text Add to dashboard Cite

show abstract

“…9 School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia. 10 School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia. 11 School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…We have demonstrated in previous analyses that the REACH intervention was effective at reducing healthcare associated infections and cost-effective to implement in hospitals [9,10]. This paper describes the development and application of the implementation strategy employed in the REACH trial, and aims to evaluate the effectiveness of this framework based approach using two quantitative measures of implementation success: post-intervention cleaning bundle alignment (an implementation measure), and cleaning performance (an outcome measure).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a structured, framework-based approach to implementation: the Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial

Hall

White

Allen³

et al. 2020

Antimicrob Resist Infect Control

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Background: Implementing sustainable practice change in hospital cleaning has proven to be an ongoing challenge in reducing healthcare associated infections. The purpose of this study was to develop a reliable framework-based approach to implement and quantitatively evaluate the implementation of evidence-based practice change in hospital cleaning. Design/methods: The Researching Effective Approaches to Cleaning in Hospitals (REACH) trial was a pragmatic, stepped-wedge randomised trial of an environmental cleaning bundle implemented in 11 Australian hospitals from 2016 to 2017. Using a structured multi-step approach, we adapted the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to support rigorous and tailored implementation of the cleaning bundle intervention in eleven diverse and complex settings. To evaluate the effectiveness of this strategy we examined post-intervention cleaning bundle alignment calculated as a score (an implementation measure) and cleaning performance audit data collected using ultraviolet (UV) gel markers (an outcome measure). Results: We successfully implemented the bundle and observed improvements in cleaning practice and performance, regardless of hospital size, intervention duration and contextual issues such as staff and organisational readiness at baseline. There was a positive association between bundle alignment scores and cleaning performance at baseline. This diminished over the duration of the intervention, as hospitals with lower baseline scores were able to implement practice change successfully. Conclusion: Using a structured framework-based approach allows for pragmatic and successful implementation of clinical trials across diverse settings, and assists with quantitative evaluation of practice change.

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“…The detailed costs of each PPE item as well as hand sanitization and soap can be found from online resources 11,12 . For Guideline #3, the cost of routine sanitization (e.g., cleaning the workplace, bathroom, and shared electronic devices) is calculated as ξ 3 = $10.45 per environmental service staff per day [32]. Specifically, in the work of White (2019), 11 hospitals with a total of 1,700 environmental service staffs, they found to spend $11,308 per week to maintain the hygiene by consuming disinfection products.…”

Section: Data Source and Parameter Valuesmentioning

confidence: 99%

Mathematical Modeling of Business Reopening When Facing SARS-CoV-2 Pandemic: Protection, Cost, and Risk

Miao

Gao

Feng

et al. 2020

Front. Appl. Math. Stat.

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The sudden onset of the coronavirus (SARS-CoV-2) pandemic has resulted in tremendous loss of human life and economy in more than 210 countries and territories around the world. While self-protections such as wearing masks, sheltering in place, and quarantine policies and strategies are necessary for containing virus transmission, tens of millions of people in the U.S. have lost their jobs due to the shutdown of businesses. Therefore, how to reopen the economy safely while the virus is still circulating in population has become a problem of significant concern and importance to elected leaders and business executives. In this study, mathematical modeling is employed to quantify the profit generation and the infection risk simultaneously from a business entity's perspective. Specifically, an ordinary differential equation model was developed to characterize disease transmission and infection risk. An algebraic equation is proposed to determine the net profit that a business entity can generate after reopening and take into account the costs associated of several protection/quarantine guidelines. All model parameters were calibrated based on various data and information sources. Sensitivity analyses and case studies were performed to illustrate the use of the model in practice. The results show that with a combination of necessary infection protection measures implemented, a business entity may stand a good opportunity to generate a positive net profit while successfully controlling the within-business infection prevalence under that in the general population. The use of personal protective equipment (PPE) is also found of significant importance, especially at the early stage of business reopening.

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

Cited by 27 publications

References 35 publications

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Effectiveness of a structured, framework-based approach to implementation: the Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial

Mathematical Modeling of Business Reopening When Facing SARS-CoV-2 Pandemic: Protection, Cost, and Risk

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