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Re: FW: Hand Hygiene Aistralia – Cost effectiveness publication

Home Forums Infexion Connexion FW: Hand Hygiene Aistralia – Cost effectiveness publication Re: FW: Hand Hygiene Aistralia – Cost effectiveness publication

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MaryLouise McLaws
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MaryLouise McLaws

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Dear Ramon and Glenys

Graves et al study relies on the accuracy of the 2 pivotal variables: SAB and hand hygiene compliance. The accuracy of the latter is serious limited. Our report in the Medical Journal of Australia (Med J Aust 2014; 200 (9):534-537. http://dx.doi.org/10.5694/mja13.11203) concluded the HHA program reports rates that have been biased upwards by very few high performers.

The conclusion from our findings and Graves et al is:

(1) SAB respond to multiple interventions and hand hygiene is only one of these.
(2) hygiene compliance rates have not reached a tipping point to reduce SAB and this tipping point is a long way off because
(3) the hand hygiene compliance rates are inaccurate.

It is important to have a national HH program. But the expense of the current program is too high when the cost of audits provides flawed data that reinforces a misguided belief that our hospitals are performing HH well.

Mary-Louise

Professor Mary-Louise McLaws

Professor of Epidemiology in Healthcare Infection and Infectious Diseases Control

http://research.unsw.edu.au/people/professor-marylouise-mclaws

SPHCM SAMUELS BUILDING

UNSW AUSTRALIA, SYDNEY NSW 2052 AUSTRALIA

CRICOS Provider Code 00098G

________________________________

Colleagues

The study by Graves et al. reports a range of interesting findings, and raises many issues regarding hand hygiene for broader consideration. The College is examining the paper and is preparing a media release for release in the coming days.

Kind regards,
Ramon

Professor Ramon Z Shaban
PRESIDENT

Australasian College for Infection Prevention and Control

GPO Box 3254, Brisbane Qld 4001

On 25 February 2016 at 21:16, Glenys Harrington <infexion@ozemail.com.au> wrote:
Dear All,

Find attached the following publication (February 9, 2016).

Graves et al. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia. PLoS ONE 11(2): e0148190. doi:10.1371/journal.

The analysis was undertaken on data from 6 Australian states:

In 2/6 states there was a 1% chance it was cost effective

In 1/6 states there was a 26% chance it was cost effective

In 1/6 states there was a 80% chance it was cost effective and

In 2/6 a 100% chance it was cost effective.

Interesting figure showing cost increases and cost savings by state (fig 2).

Also some interesting points in the discussion.

Shame there was No useable pre-implementation data available for Victoria and hence was not able to be analysed.

Given the findings of the analysis it raises the following questions for governments:

Shouldnt the program be scaled back and some of the money be spent on other initiatives to reduce hospitals associated infections(HAIs)?

Shouldnt the program be scaled back to reduce the infection control workload associated with the program which is currently overwhelming and taking ICPs away from other core infection control activities?

A press release by the College about the findings of this study and the views of the college in terms of the allocation of limited resources would be timely.

regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

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