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Evaluating the clinical and cost effectiveness of educational interventions for preventing vascular catheter bloodstream infections in critical care

Evaluating the clinical and cost effectiveness of educational interventions for preventing vascular catheter bloodstream infections in critical care
Evaluating the clinical and cost effectiveness of educational interventions for preventing vascular catheter bloodstream infections in critical care
Background - Vascular catheter bloodstream infections (catheter-BSI) increase patients’ morbidity in critical care. Catheter-BSI are thought to be preventable using educational interventions to promote evidence-based clinical practices. However, it is unclear which interventions would be the most clinically and cost effective in NHS settings.

Aims / objectives - To assess the clinical and cost effectiveness of educational interventions for preventing catheter-BSI in critical care units in England

Methods - We conducted a systematic review of primary studies of clinical effectiveness and an economic evaluation. A decision analytic economic model compared an educational intervention to existing clinical practice to estimate associated costs, mortality and lifetime survival.

Results - Twenty four studies met the inclusion criteria of the systematic review. The studies varied widely in their temporal and spatial scales and types of educational approach they used. The majority (19) were uncontrolled before-after studies. Only two studies were conducted in the UK. Risk of bias was difficult to assess due to poor reporting. Where possible, data from the systematic review were used to inform the economic evaluation. Model results showed that implementing an educational intervention could reduce catheter-BSI incidence and total costs compared to existing clinical care, potentially resulting in cost savings to the NHS.

Conclusion - Educational interventions appear promising for preventing catheter-BSI but there is a need to improve the rigour of the primary studies to avoid bias and confounding. Coordinated, systematic collection of infection incidence data, and improved accuracy in the reporting of study settings and educational interventions would reduce the reliance on primary evidence from other countries.
Frampton, Geoff
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Harris, P.
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Cooper, K.
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Cooper, T
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Cleland, J
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Jones, Jeremy
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Shepherd, J.
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Clegg, A.
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Graves, N
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Welch, K.
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Cuthbertson, B.H.
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Frampton, Geoff
26c6163c-3428-45b8-b8b9-92091ff6c69f
Harris, P.
65908d3a-d64f-436d-829a-fd500923515b
Cooper, K.
ea064f58-d71d-404a-bcf3-49d243b8825b
Cooper, T
a12b6fee-71ca-4d1b-9dcd-8cd9789bf7b1
Cleland, J
d43e9ce4-9b7a-4bf6-988d-c0153ad3ddb3
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Shepherd, J.
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Clegg, A.
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Graves, N
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Welch, K.
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Cuthbertson, B.H.
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Frampton, Geoff, Harris, P., Cooper, K., Cooper, T, Cleland, J, Jones, Jeremy, Shepherd, J., Clegg, A., Graves, N, Welch, K. and Cuthbertson, B.H. (2012) Evaluating the clinical and cost effectiveness of educational interventions for preventing vascular catheter bloodstream infections in critical care. 8th International Healthcare Infection Society and Federation of Infection Societies (HIS/FIS) Annual Conference 2012, Liverpool, United Kingdom. 19 - 21 Nov 2012.

Record type: Conference or Workshop Item (Poster)

Abstract

Background - Vascular catheter bloodstream infections (catheter-BSI) increase patients’ morbidity in critical care. Catheter-BSI are thought to be preventable using educational interventions to promote evidence-based clinical practices. However, it is unclear which interventions would be the most clinically and cost effective in NHS settings.

Aims / objectives - To assess the clinical and cost effectiveness of educational interventions for preventing catheter-BSI in critical care units in England

Methods - We conducted a systematic review of primary studies of clinical effectiveness and an economic evaluation. A decision analytic economic model compared an educational intervention to existing clinical practice to estimate associated costs, mortality and lifetime survival.

Results - Twenty four studies met the inclusion criteria of the systematic review. The studies varied widely in their temporal and spatial scales and types of educational approach they used. The majority (19) were uncontrolled before-after studies. Only two studies were conducted in the UK. Risk of bias was difficult to assess due to poor reporting. Where possible, data from the systematic review were used to inform the economic evaluation. Model results showed that implementing an educational intervention could reduce catheter-BSI incidence and total costs compared to existing clinical care, potentially resulting in cost savings to the NHS.

Conclusion - Educational interventions appear promising for preventing catheter-BSI but there is a need to improve the rigour of the primary studies to avoid bias and confounding. Coordinated, systematic collection of infection incidence data, and improved accuracy in the reporting of study settings and educational interventions would reduce the reliance on primary evidence from other countries.

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More information

e-pub ahead of print date: November 2012
Venue - Dates: 8th International Healthcare Infection Society and Federation of Infection Societies (HIS/FIS) Annual Conference 2012, Liverpool, United Kingdom, 2012-11-19 - 2012-11-21
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 352094
URI: http://eprints.soton.ac.uk/id/eprint/352094
PURE UUID: 5389f8b3-1fac-4583-be06-7dc560d1fe66
ORCID for Geoff Frampton: ORCID iD orcid.org/0000-0003-2005-0497
ORCID for J. Shepherd: ORCID iD orcid.org/0000-0003-1682-4330

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Date deposited: 02 May 2013 12:54
Last modified: 18 Feb 2021 16:44

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Contributors

Author: Geoff Frampton ORCID iD
Author: P. Harris
Author: K. Cooper
Author: T Cooper
Author: J Cleland
Author: Jeremy Jones
Author: J. Shepherd ORCID iD
Author: A. Clegg
Author: N Graves
Author: K. Welch
Author: B.H. Cuthbertson

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