Improving outcomes and reducing costs by modular training in infection control in a resource-limited setting.
OBJECTIVE
To study the impact of modular training and implementation of infection control practices on all health-care-associated infections (HAIs) in a cardiac surgery (CVTS) program of a tertiary care hospital.


METHODS
Baseline data were compared with post-intervention (with modular training) data.


METHODS
This study was conducted in a cardiovascular surgical unit.


METHODS
In total, 2838 patients were admitted in cardiovascular surgical service.


METHODS
Two training modules and online continuous education were delivered to all health-care workers in CVTS unit.


METHODS
All four HAIs, such as surgical site infections (SSI), central line-associated blood stream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CA-UTI), were studied. Additional outcome measures included average length of stay cost of avoidance mortality and readmission rates.


RESULTS
The SSI rate had decreased in the post-intervention phase from 46 to 3.27% per 100 surgeries (P < 0.0001), CLABSI had decreased from 44 to 3.10% per 1000 catheter days (P < 0.009), VAP was reduced from 65 to 4.8% per 1000 ventilator days (P < 0.0001) and CA-UTI had reduced from 37 to 3.48% per 1000 urinary catheter days (P < 1.0). For every $1 spent on training, the return on investment was $236 as cost of avoidance of healthcare associated infections (HAIs).


CONCLUSIONS
Standardization of infection control training and practices is the most cost-effective way to reduce HCAIs and related adverse outcomes.
Amrita Institute of Medical Sciences, Ponekkara Post, Kochi, Kerala 682041, India. sanjeevksingh@aims.amrita.edu
Sanjeev
S
Singh
Raman Krishna
RK
Kumar
Karimassery R
KR
Sundaram
Barun
B
Kanjilal
Prem
P
Nair
D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects; D055499:Catheter-Related Infections / Q000191:economics / Q000517:prevention & control; D003365:Costs and Cost Analysis; D003428:Cross Infection / Q000191:economics / Q000517:prevention & control*; D004496:Education, Continuing / Q000458:organization & administration; D005260:Female; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D017053:Infection Control / Q000191:economics* / Q000458:organization & administration*; D007318:Inservice Training / Q000191:economics* / Q000458:organization & administration*; D007362:Intensive Care Units / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000191:economics / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000191:economics / Q000517:prevention & control; D062606:Tertiary Care Centers / Q000458:organization & administration