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Infection Prevention Saves Lives and Money

 |  By Alexandra Wilson Pecci  
   January 20, 2015

Preventing two of the most common healthcare-associated infections reduces the cost of patient care by more than $150,000. The cost of running an infection prevention program in the ICU is about $145,000.

Preventing infections in the ICU not only saves lives; it also saves money, finds a new study published in the American Journal of Infection Control.

The study found that elderly patients admitted to ICUs are about 35% more likely to die within five years of leaving the hospital if they develop an infection during their stay.

Preventing two of the most common healthcare-associated infections (HAIs) not only increases their survival odds but also reduces the cost of their care by more than $150,000.

Those two HAIs—central line-associated bloodstream infections (CLABSI) and ventilator-associated pneumonia (VAP)—are preventable, says senior study author Patricia Stone, Centennial Professor of Health Policy and Director of the Center for Health Policy at Columbia University School of Nursing.

Patricia Stone

A report released by the Centers for Disease Control and Prevention last week shows significant reductions at the national level in 2013 for nearly all HAIs. Still, "just one HAI is one too many," Stone told me via email.

This new study shows that it pays to prevent infections, finding that on average, the ongoing cost of running an infection prevention program in the ICU is about $145,000. Those prevention efforts reduced ICU costs by $174,713 per patient for each instance of CLABSI, and by $163,090 for VAP.

In addition to cost-effectiveness, the study found that proper CLABSI prevention efforts resulted in an estimated gain of 15.55 years of life on average for all patients treated in the ICU. Efforts to prevent VAP resulted in an estimated gain of 10.84 years of life.

But just because prevention protocols are in place doesn't mean they're being followed. For instance, another study that Stone lead last year showed that when it comes to CLABSI, 92% of ICUs had a policy for an insertion checklist, but only 52% of the healthcare professionals were seen to adhere to that policy.

For VAP prevention, the results were similar: 74% of ICUs had a ventilator bundle checklist, but only 52% of those treating patients adhered to it.

HAIs are nurse-sensitive outcomes, but nurses aren't alone in the need to adhere to prevention protocols. They can, however, act as leaders in adhering to protocols, and can use the new study findings to bolster or implement HAI prevention programs. I chatted with Stone via email to learn more.

HLM: What surprised you most about the study findings?

Stone: While I thought infection prevention and control would be cost-effective due to the high attributable costs associated with these infections, I was surprised at how cost-effective multifaceted infection prevention programs were. I was also surprised how robust these finding[s] were to a number of assumptions.

HLM: What would you say are the most significant findings and why?

Stone: The most significant findings were that infection prevention not only saves lives, it also saves money. In the current constrained economic environment in hospitals with many cost-cutting measures being put in place coupled with the focus on quality, it is important to know that investments in infection prevention pay off in terms of decreased HAIs and improved economic outcomes.

HLM: What lessons or takeaways are there for nurse leaders and nurse executives? Are there lessons for charge nurses on units, or nurses specializing in infection control, or for nurses in the higher ranks of executive leadership?

Stone: Nurse leaders and executives should know that investment in infection prevention should remain a high priority. Nurse managers should be supportive of infection prevention efforts. Nurses specializing in infection control may want to use these findings in reports to administration and hospital boards to ensure investment in their departments.

HLM: What should nurse leaders have staff do differently based on these study findings?

Stone: Many hospitals are already investing in infection prevention and have well developed programs that help bedside nurses provide the best-evidence based care at the bedside. If the hospital the nurse works in doesn't [have such a program] they [nurse leaders] should try to make sure it [gets one].

They could use these findings to try to get the investment in infection prevention showing how it pays off in the end. But, even in the hospitals with well developed programs, there are still HAIs occurring and just one HAI is one too many.

Furthermore, the HAIs are increasingly caused by emerging or resistant organisms. We need to emphasize the need for compliance with guidelines to deliver the highest quality care.

HLM: What findings do you think might be most surprising to nursing executives?

Stone: How cost-effective infection prevention can be!

Alexandra Wilson Pecci is an editor for HealthLeaders.

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