title: Are educational interventions to prevent catheter-related bloodstream infections in intensive care unit cost-effective?
abstract: BACKGROUND
  There is increasing interest in evidence-based educational interventions in central venous catheter care. It is unclear how effective these are at reducing the risk of bloodstream infections from the use of intravascular catheters (catheter-BSIs) and the associated costs and health benefits.
  
  
  OBJECTIVE
  To estimate the additional costs and health benefits from introducing such interventions and the costs associated with catheter-BSIs.
  
  
  METHODS
  A comprehensive epidemiological and economic review was performed to develop the parameters for an economic model to assess the cost-effectiveness of introducing an educational intervention compared with clinical practice without the intervention. The model follows the clinical pathway of cohorts of patients from their admission to an intensive care unit (ICU), where some may acquire catheter-BSI, and estimates the associated costs, mortality and life expectancy.
  
  
  RESULTS
  The additional cost per catheter-BSI episode was £3940. The results of this model demonstrate that introducing an additional educational intervention to prevent catheter-BSI improved patient life expectancy and reduced overall costs.
  
  
  CONCLUSIONS
  Introducing evidence-based education is likely to reduce the incidence of catheter-BSI and the model results suggest that the cost of introducing the interventions will be outweighed by savings related to reduced ICU bed occupancy costs.
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK. Electronic address: k.cooper@soton.ac.uk.
authors.forename: K
authors.initials: K
authors.lastname: Cooper
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK.
authors.forename: G
authors.initials: G
authors.lastname: Frampton
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK.
authors.forename: P
authors.initials: P
authors.lastname: Harris
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK.
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.affiliation: South London Healthcare NHS Trust, Sidcup, UK.
authors.forename: T
authors.initials: T
authors.lastname: Cooper
authors.affiliation: Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Graves
authors.affiliation: Foresterhill Health Centre, University of Aberdeen, Aberdeen, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cleland
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK.
authors.forename: J
authors.initials: J
authors.lastname: Shepherd
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK.
authors.forename: A
authors.initials: A
authors.lastname: Clegg
authors.affiliation: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: B H
authors.initials: BH
authors.lastname: Cuthbertson
mesh_terms: D055499:Catheter-Related Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D004501:Education, Medical / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*
keywords: Care bundle; Catheter bloodstream infection; Central venous catheter; Cost-effectiveness; Educational intervention