Reduction Of Hospital-acquired Infections Research Articles

Incidence of hospital-acquired infections among healthcare workers in Egypt before and during the COVID-19 pandemic

Background: Hospital-acquired infection is higher among healthcare workers (HCWs) than among other occupational groups, and the COVID-19 pandemic exacerbated its incidence. Aim: To assess the incidence of hospital-acquired infections among HCWs in, Cairo, Egypt, during the COVID-19 pandemic. Methods: This retrospective cohort study collected and evaluated data on hospital-acquired infections (excluding COVID-19) from 1660 nurses, physicians, technicians, and housekeepers in 6 hospitals in Cairo Governorate, Egypt, 1 year before and 1 year during the COVID-19 pandemic. The data were analysed using SPSS version 21.0 and descriptive and inferential statistics were used to test the magnitude and direction of relationships between the variables. Results: The rate of hospital-acquired infections was 3.1% before and 1.3% during the COVID-19 pandemic. There was a significantly lower risk of hospital-acquired infection among the HCWs during the pandemic than before it. Incidence was highest among housekeepers (10.6%), and physicians had the highest relative risk (4.33). Before the pandemic, pneumonia was the most common hospital-acquired infection (20.8%) among HCWs, while hepatitis C was the most common (8.3%) during the pandemic. The most significant predictors of hospital-acquired infection were COVID-19 (before and during the pandemic), working area and profession. Conclusion: There was a significant reduction in hospital-acquired infections among HCWs during the COVID-19 pandemic, attributed to increased adherence to infection prevention and control measures. Housekeepers, nurses and emergency department workers were at higher risk, indicating the need for further investigations among these groups of HCWs to understand the contributing factors and design targeted interventions to lower the risks and incidence.

Evaluating the Effect of Financial Penalty on Hospital-Acquired Infections.

This study explores the effects of CMS reimbursement financial penalties from the Hospital-Acquired Condition Reduction Program (HACRP) on hospital-acquired infections (HAI) in hospitals across the United States. Hospital-level data for 2896 hospitals in the United States were evaluated using multiple linear regression models with random effects analysis through a difference-in-differences study design to examine HAIs under the HACRP between hospitals that were financially penalized or not from calendar years 2013 to 2020. This study showed significant differences from the pre-program Total HAC scores to the most recent reviewed year, validating the efficacy of the HACRP, and showing a reduction of overall HAIs over the years evaluated in the study. The multiple linear regression model with random effects analysis produced a significant (p < 0.001) interaction term between hospitals expected to be penalized in 2013 and each year evaluated in the study (-0.412 estimate) confirming decreases in HAI scores, and overall decreases in HAIs across the years of the study. Notably, 98% of hospitals in the worst-performing, expected to be financially penalized quartile from 2013, were found to have decreased their HAIs in their facilities, while only 38.8% of hospital in the performing, non-penalized quartiles showed decreases in HAIs across their facilities, by 2020. Our research indicates that implementing financial disincentives through reimbursement reductions could potentially decrease the incidence of HAIs. Our study further suggests that incorporating financial penalties and incentives for HAIs annually across all hospitals may lead to significant reductions in HAIs throughout the US healthcare system.

Reduction of Hospital-Acquired Infections Through a Nursing Education Program: A Quality Improvement Project on the Sensitization of Nursing Staff Toward Infection Control in Neonates.

Background This study aimed to reduce hospital-acquired infections (HAIs) by at least 50% in our unit through a nursing education program to sensitize the nursingstafftoward infection control in neonates. Methodology This pre- and post-intervention observational study was conducted in Liaquat National Hospital's Neonatal Intensive Care Unit (NICU) from October 2021 until March 2023. This observational study was conducted in three phases. In phase I (pre-implementation), all neonates with suspected HAIs were included. In phase II (implementation), the nursing staff dedicated to the NICU were trained. In phase III (post-implementation), all neonates with suspected HAIs were included. Culture-proven bloodstreaminfections (BSIs), urinary tract infections (UTIs), and ventilator-associated pneumonia (VAP) were the three types of HAIs. The nursing scoring was done by the principal investigator based on a questionnaire. The Shapiro-Wilk test was used to evaluate the normality of all quantitative data across all phases. Results In the pre-implementation phase, there were 24 (10.8%) HAIs, among which 19 (8.6%) were BSIs, one (0.5%) was a catheter-associated urinary tract infection (CAUTI), and seven (3.2%) were VAP. Whereas in the post-implementation phase, there were 12 (5%) HAIs, among which 10 (4.1%) were BSIs, none were CAUTIs, and five (2.1%) were VAP. Therewas a significant reduction of HAIs in the post-implementation phase (p < 0.01). The difference in the knowledge, assessment, and practice was statistically significant in the post-implementation phase (p < 0.01). Conclusions We established a successful cost-effective intervention to improve theawareness and compliance of NICU nurses with infection control practices. This helped us in reducing HAIs in our NICU.

An intervention study investigating the effectiveness of contextualizing multimodal strategy on improving hand hygiene at a tertiary hospital in Nigeria.

Hand hygiene (HH) is a proven low-cost means to curtail the problem of hospital-acquired infection (HAI). However, a low HH compliance rate of 17.1% was found among surgical health workers at Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria. This was an intervention study conducted utilizing mixed methods to investigate the effectiveness of the World Health Organization (WHO) multimodal strategy to improve the HH compliance rate of doctors at ABUTH Zaria. The study was conducted between June and August 2022 and included delivering a behavioural change HH workshop to doctors followed by data collection in the surgical wards that had received environmental modification through the provision of an alcohol-based hand rub (ABHR), HH posters and nurses for visual and/or verbal reminders. The cumulative HH compliance rate was 69% (n=1774) and was significantly different from the baseline HH compliance rate of 17.1% (confidence interval 45.5 to 57.7, p<0.001). Observed HH was highest in the ward with both visual and verbal reminders (78%) and lowest (59%) where neither visual nor verbal reminders were provided (n=444 per ward). All respondents reported motivation to perform HH with the presence of ABHR. The WHO multimodal strategy is good for enhancing HH among health workers in the context of low- and middle-income countries. More research is needed to understand how much of a reduction in HAI is directly associated with efficient HH by health workers.

Incorporating Near Infrared Light Vein Visualization Technology Into Peripheral Intravenous Access Protocols.

Placement of peripheral intravenous catheters (PIVCs) is a frequent occurrence. Yet, PIVCs consistently require multiple attempts for successful cannulation, leading to an increased use of resources and risk of complications. Even though hospitals have established vascular access teams to improve outcomes and increase longevity of PIVCs, not every facility has one, and some struggle to meet demand. In these cases, PIVC placement depends on the confidence and skills of bedside nurses. Difficult access risk identification tools, as well as vein visualization technologies, like near infrared (nIR), have been developed to assist nurses with cannulation. This study sought to explore how hospitals are using vein visualization technology in nurse-driven protocols and to evaluate whether the technology is being meaningfully integrated into venous assessment and PIVC access protocols. In a survey sent to facilities utilizing nIR technology, 48% of respondents incorporated nIR in nurse-driven protocols. Of these respondents, 88% reported improvement in patient satisfaction, 92% saw a reduction in escalations, and 79% reported a reduction in hospital-acquired infections associated with PIVC placement. Integrating vein visualization technology into nurse-driven PIVC placement protocols has the potential to make a positive impact but requires future research to reproduce these findings in clinical studies.

Infection prevention and control programme and COVID-19 measures: Effects on hospital-acquired infections in patients with cirrhosis

Bacterial infections affect survival of patients with cirrhosis. Hospital-acquired bacterial infections present a growing healthcare problem because of the increasing prevalence of multidrug-resistant organisms. This study aimed to investigate the impact of an infection prevention and control programme and coronavirus disease 2019 (COVID-19) measures on the incidence of hospital-acquired infections and a set of secondary outcomes, including the prevalence of multidrug-resistant organisms, empiric antibiotic treatment failure, and development of septic states in patients with cirrhosis. The infection prevention and control programme was a complex strategy based on antimicrobial stewardship and the reduction of patient's exposure to risk factors. The COVID-19 measures presented further behavioural and hygiene restrictions imposed by the Hospital and Health Italian Sanitary System recommendations. We performed a combined retrospective and prospective study in which we compared the impact of extra measures against the hospital standard. We analysed data from 941 patients. The infection prevention and control programme was associated with a reduction in the incidence of hospital-acquired infections (17 vs. 8.9%, p <0.01). No further reduction was present after the COVID-19 measures had been imposed. The impact of the infection prevention and control programme remained significant even after controlling for the effects of confounding variables (odds ratio 0.44, 95% CI 0.26-0.73, p= 0.002). Furthermore, the adoption of the programme reduced the prevalence of multidrug-resistant organisms and decreased rates of empiric antibiotic treatment failure and the development of septic states. The infection prevention and control programme decreased the incidence of hospital-acquired infections by nearly 50%. Furthermore, the programme also reduced the prevalence of most of the secondary outcomes. Based on the results of this study, we encourage other liver centres to adopt infection prevention and control programmes. Infections are a life-threatening problem for patients with liver cirrhosis. Moreover, hospital-acquired infections are even more alarming owing to the high prevalence of multidrug-resistant bacteria. This study analysed a large cohort of hospitalised patients with cirrhosis from three different periods. Unlike in the first period, an infection prevention programme was applied in the second period, reducing the number of hospital-acquired infections and containing multidrug-resistant bacteria. In the third period, we imposed even more stringent measures to minimise the impact of the COVID-19 outbreak. However, these measures did not result in a further reduction in hospital-acquired infections.

Proven Impact of an Advanced Air Purification System in the Reduction of Infectious Airborne and Surface Pathogens, Concomitant Reduction of Hospital-acquired Infections and Length of Stay, and Improvement in Health-care Economics.

Proven Impact of an Advanced Air Purification System in the Reduction of Infectious Airborne and Surface Pathogens, Concomitant Reduction of Hospital-acquired Infections and Length of Stay, and Improvement in Health-care Economics.

Reducing hospital-acquired infections and improving the rational use of antibiotics in a tertiary care hospital in Bangalore

Prevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries.To assess the effectiveness of a multifaceted infection control and antibiotic stewardship programme on HAIs and antibiotic use. A retrospective study was conducted for a study period of 11months (June 2021-April 2022) in Vydehi Hospital, Bangalore. All patients admitted to the intensive care unit and wards were included in the study. Intervention period was 6 months (June 2021-Nov 2021) and post-intervention period was 5 months (Dec 2021- April 2022). Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of hand hygiene campaign, isolation of multidrug resistance organism’s patients, water and air quality analysis, training of health care workers in infection control practices, and antibiotic stewardship. Data was collected using an identical method in the intervention and post intervention periods.We observed a major reduction in HAIs, from 89% (198/222 patients) in the intervention period to 10.8% (24/222 patients) in the post intervention period (relative risk (RR) (95% CI) 0.48 (0.31 to 0.56). Antibiotic use in ICUs declined from 58% (780/1347) to 44% (442/995) (RR 0.44 (0.40 to 0.55). Overall, hand hygiene compliance among the health- care workers was maintained at 100% during both the periods. Multifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised patients in developing countries.

Impact of dry hydrogen peroxide on hospital-acquired infection at a pediatric oncology hospital

BackgroundThis study aims to describe the effect of Dry Hydrogen Peroxide (DHP), as an adjunct to environmental cleaning and disinfection, on the incidence of hospital-acquired infections (HAIs) at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala City, Guatemala. MethodsA retrospective study of all HAI data from the hospital's surveillance system, which follows Centers for Disease Control and Prevention (CDC) protocols, was conducted from January 2019 to November 2020. DHP was installed in all Pediatric Intensive Care Unit (PICU) rooms in January 2020, but nowhere else in the hospital, including the Intermediate Care Unit (IMCU). ResultsThere were 189 HAI cases during the study period, with 173 occurring in either the PICU or IMCU. A statistically significant decrease in HAI incidence rates occurred in the PICU in 2020 compared to 2019 (P = .028), including Clostridiodes-associated gastroenteritis (P = .048). Logistic multivariate regression yielded a significant association between DHP exposure and reduced odds of developing an HAI during the study (OR = 0.3857, P = .029). ConclusionThe use of DHP as an adjunct technology for environmental cleaning and disinfection contributed to the reduction in HAIs in the PICU. Our study highlights the value of such an approach as an addition to manual cleaning to decrease the risk of infection from environmental contamination.

Polyherbal Natural Hand Sanitizer Formulation and Evaluation

Making a polyherbal hand sanitizer’s major purpose is to increase “hand hygiene.” In the prevention, control, and reduction of hospital-acquired infections, hand hygiene is a key principle and practice. The plants were validated using fresh Azadirachta indica and Tridax procumbens leaves. The leaves were cleaned, dried in the shade, and used for future research. Using the Soxhlate equipment and hydroalcoholic solvent extraction, several phytochemicals were extracted, and the recovered phytochemicals were qualitatively examined before being evaluated for antibacterial activity. This herbal extract blend was used to make hand sanitizer. Herbal hand sanitizer was evaluated using microorganism suspensions (Bacteria- E. coli, Staphylococcus aureus), which showed that herbal hand sanitizer is more efficient than commercial synthetic hand sanitizer in reducing the number of germs on the hands. The increased antibacterial activity and efficacy of these plant extracts can be exploited to create herbal hand sanitizers on a commercial scale. When the ingredients are mixed together, they form a hand sanitizer.

The effect of probiotics for environmental cleaning on hospital-acquired infection in a burn centre: The results of a non-randomised controlled prospective study

Background. A retrospective analysis was done to correlate recorded clinical infections with laboratory cultures to report on the incidence of hospital-acquired infections (HAIs) and the impact of probiotics for environmental cleaning in our burn centre. Objectives. To assess the effect of probiotics for environmental cleaning in a tertiary burn unit on HAIs. Methods. We used the electronic content management system of the hospital to access patient files for 2017 and February 2018. All patients with clinical records showing a new infection after admission for ≥48 hours and who required antibiotics were recorded as HAIs. Results. The total number of HAIs for 2017 was 167. If the two test months (TM) when probiotics were used are excluded for 2017, then the HAIs numbered 151 for the remaining control months (CM). Thus during 2017 there were 16 HAIs in the TMs. The percentage difference of the monthly average of HAIs for the TM and the CM is a 55.89% reduction, with a statistically significant p-value &lt;0.005. Conclusion. Our reduction in HAIs is consistent with the findings of other high-level-of-evidence studies in the literature. We can recommend the use of probiotics for environmental cleaning in a burn centre.

Multi-Facility Reduction in Hospital-Acquired Infections (HAIs) Through Real-Time Feedback and Individual Accountability

Background: Hospital-acquired infections (HAIs) are a leading cause of healthcare morbidity and cost for the health community. It is widely recognized that hand hygiene is the leading contributor infections, but hand hygiene still remains a major problem for nearly all healthcare systems. A longitudinal study was conducted over a 4-year period in a community-based health system. Methods: An electronic hand hygiene reminder system was installed in 2 different facilities including both critical care and noncritical units. This system collects data on individual healthcare provider hand hygiene and provides a real-time voice reminder in the event that a provider forgets to perform hand hygiene. The primary study was designed to investigate the impact of a real-time voice reminder to improve hand hygiene. A baseline period of hand hygiene was established prior to the interventions after installing the system without any access to data reporting or the voice reminder. Each of the hospitals had the voice reminder turned on and off 3 times. The baseline HAI rates were established by comparing in each facility for the 12 months prior to the implementation of the system. During the study period, there were no significant changes to other common infection control practices. Results: In both facilities, every time the voices were turned on, hand hygiene improved significantly and each clinical unit saw a &gt;200% improvement in hand hygiene within 3 months of turning the voice reminder. HAIs fell by a statistically significant in all clinical areas by 51%. After a period of stabilization, the voice reminder was turned off hand hygiene compliance fell and HAI rates then increased. The voice reminder was then turned back on and off 2 more times. In every case, hand hygiene rates fell back to the baseline and HAIs returned to their baseline. When the voice reminder was then turned back on, HAIs dropped to 54%–81% of the baseline in each of the clinical units. The system also captured individual providers’ hand hygiene performance data and displayed it in a simple and engaging way, allowing managers easily understand who was struggling with hand hygiene. These data were then leveraged through a series of competitions to systematically drive hand hygiene performance improvement. These included traditional interventions to address an education issue in addition to interventions to identify workflow problems. Conclusions: Using this highly targeted approach, the leadership were able to efficiently drive sustained hand hygiene improvement and a further reduction in HAIs.Funding: NoneDisclosures: None

Maximizing efficiency in a high occupancy setting to utilize ultraviolet disinfection for isolation rooms

Ultraviolet (UV) disinfection decreases nosocomial disease rates in acute care settings; effective program implementation is poorly understood. We developed a program to UV-disinfect rooms following discharge of patients in transmission-based precautions (TBP) and assessed its effect on hospital-acquired infection (HAI) rates. An isolation room housed a patient in any type of TBP. A priority room was an isolation room in TBP for multidrug resistant organisms or Clostridioides difficile infection. Percent rooms disinfected and HAI rates were calculated monthly. The two-robot program was started by Infection Prevention utilizing a single environmental services employee. Efficiency was increased by granting environmental services' personnel oversight, increasing coverage, and modifying shift-based goals. Our primary goal was disinfection of all discharged priority rooms. Our secondary goal was disinfection of all discharged isolation rooms. The program achieved 6-month disinfection averages of 85.7% of isolation, and 87.7% priority rooms, respectively. Using a dedicated UV disinfection team and setting isolation room per shift goals improved coverage. HAI rates decreased by 16.2% following program implementation. We implemented an effective UV disinfection program, and observed HAI reduction, by focusing on broad coverage and efficient deployment of assets without affecting patient flow or expanding the robot fleet.

The damage response framework and infection prevention: From concept to bedside.

Hospital-acquired infections remain a common cause of morbidity and mortality despite advances in infection prevention through use of bundles, environmental cleaning, antimicrobial stewardship, and other best practices. Current prevention strategies and further hospital-acquired infection reduction are limited by lack of recognition of the role that host-microbe interactions play in susceptibility and by the inability to analyze multiple risk factors in real time to accurately predict the likelihood of a hospital-acquired infection before it occurs and to inform medical decision making. Herein, we examine the value of incorporating the damage-response framework and host attributes that determine susceptibility to infectious diseases known by the acronym MISTEACHING (ie, microbiome, immunity, sex, temperature, environment, age, chance, history, inoculum, nutrition, genetics) into infection prevention strategies using machine learning to drive decision support and patient-specific interventions.

Building a Practice-Focused Academic-Practice Partnership.

A practice-focused academic-practice partnership merging the strengths and resources of 2 faith-based community organizations built evidence-based practice, nursing research, and innovative nursing programs. The unique partnership emphasizing quality care and patient outcomes resulted in hospital-acquired infection reduction, interventional research reducing readmissions, clinical redesign, increased percentage of bachelor's degree-prepared nurses, and dissemination through publication and presentation. Key elements to partnership success were shared mission and vision, program oversight, strong contract, and annual plans with specific measurable outcomes.

Utilizing a Business Case to Link Reduction in Infections to Reduction in?Costs

BACKGROUND A review of literature indicates that expanding chlorhexidine gluconate (CHG) bathing beyond those at high risk to all patients can reduce hospital-acquired infection (HAI) rates. However, infection prevention strategies are often viewed as soft costs and difficult to fund despite HAI prevention being associated with significant cost avoidance. METHODS In February 2017 a task force was assembled to assess risk mitigation. A return on investment (ROI) was compiled for leadership highlighting the potential cost benefit of decreasing Central Line Associated Bloodstream Infections (CLABSI), Catheter Associated Urinary Tract Infections (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA) bacteremia and Clostridium Difficile HAIs by expanding CHG use. We calculated the total cost of HAIs from 2016, including Centers for Medicare and Medicaid Hospital Acquired Condition Reduction Program (CMS HACRP) penalty (fiscal year 2017) [100% attribution to HAIs], direct cost and cost impact of HAI reduction using CHG bathing in current high risk populations and projected reductions and cost savings based on literature reviews and applied to all patients house-wide. On April 4, 2017 house-wide CHG bathing for all patients was implemented. Intensive staff education was provided with both face-to-face and electronic educational sessions with reinforcement at the annual employee quality fair. Compliance was measured by routine audits (chart reviews, unit rounds and staff feedback). RESULTS House-wide CHG bathing realized a CLABSI reduction of 65%. With a $17,445 direct cost per CLABSI, our total cost impact of reduction for this HAI was $226,785. Other infection decreases attributed to CHG bathing ranged from 28%-30%, raising the cost impact of HAI reduction to $439,803. CHG bathing costs totaled $40,114.10. CONCLUSIONS Identifying and quantifying the costs and benefits attributable to reduced HAIs at the facility level allows Infection Preventionists to present a business case necessary to justify program initiatives and drive improvement.

Central Line-Associated Blood Stream Infections and Non–Central Line-Associated Blood Stream Infections Surveillance in Canadian Tertiary Care Neonatal Intensive Care Units

To determine if the reported reduction in hospital-acquired infections is due to reduced central line-associated blood stream infections (CLABSI) or non-CLABSIs. A retrospective cohort study design was used to describe the change in organism pattern and incidence of hospital-acquired infections (CLABSIs and non-CLABSIs) in neonates <33weeks of gestation admitted to tertiary neonatal intensive care units in the Canadian Neonatal Network between January 1, 2010, and December 31, 2016. Hospital-acquired infection was diagnosed when a pathogenic organism was isolated from blood or cerebrospinal fluid in a neonate with suspected sepsis. CLABSI was diagnosed when a central venous catheter was present at the time or removed in the 2days before a hospital-acquired infection diagnosis. Cochran-Armitage and Mann-Kendall trend tests and linear regression models were used for statistical analyses. Of 28 144 eligible neonates from 30 Canadian Neonatal Network neonatal intensive care units, 3306(11.7%) developed hospital-acquired infections. There was a significant decrease in the rate of hospital-acquired infections (14.2% in 2010 and 9.2% in 2016; P<.01), and the rate of both CLABSIs and non-CLABSIs (P<.01) over the study period concomitant with a significant decrease in the duration of central line use (P=.01). The rates of meningitis also decreased during the study period (1.2% in 2010 and 0.9% in 2016; P<.01). Infections owing to gram-positive cocci significantly decreased, but infections owing to gram-negative organisms remained unchanged. Although there was a significant decrease in CLABSIs and non-CLABSIs, hospital-acquired infections in preterm neonates remained high. Infections owing to gram-negative organisms remained unchanged and are a target for future preventative efforts.

Reduction of hospital-acquired infections in the neonatal intensive care unit: A long-term commitment

We instituted quality improvement program. We compare the infection rate before (2011-2012) and after (2013-2015). Central line associated blood stream infection episodes decreased from 15.2 to 2.29 episodes per 1000 catheter days (P = .004). We found two major changes, 1. Hand hygiene increased mainly "before aseptic task", from 69.9% to 89.9% and 2. A significant decrease in the length of the catheter use from 5.4 ± 4.5 before to 4.4 ± 2.5 days after the intervention (P = .001).

Hospital Infection Prevention: How Much Can We Prevent and How Hard Should We Try?

To summarize the extent to which hospital-acquired infections (HAIs) are preventable and to assess expectations, challenges, and barriers to improve patient outcomes. HAIs cause significant morbidity and mortality. Getting to zero HAIs is a commonly stated goal yet leads to unrealistic expectations. The extent to which all HAIs can be prevented remains debatable and is subject to multiple considerations and barriers. Current infection prevention science is inexact and evolving. Evidence-based infection prevention practices are often incompletely implemented and at times controversial. Highly sensitive surveillance results in overdiagnosis, calling into question the real incidence of HAIs. Perceived reductions in HAIs by gaming the system lead to false conclusions about preventability and may cause harm. Successful HAI reduction programs require executive oversight yet keeping hospital leaders engaged in infection prevention is a challenge given competing priorities. Medicine is not a physical science with precisely defined laws; thus, infection prevention interventions are subject to variable outcomes. Perhaps up to 55-70% of HAIs are potentially preventable. This is subject to a law of diminishing returns as the preventable proportion of HAIs may reduce over time with improvements in patient safety. As the principle tenet of medicine is first do no harm, infection prevention programs should relentlessly pursue reliable, sustainable, and practical strategies for heightened patient safety.

Clinical, operational, and financial impact of an ultraviolet-C terminal disinfection intervention at a community hospital

Hospital-acquired infections (HAIs) are a significant contributor to adverse patient outcomes and excess cost of inpatient care. Adjunct ultraviolet-C (UV-C) disinfection may be a viable strategy for reducing HAIs. This study aimed to measure the clinical, operational, and financial impact of a UV-C terminal disinfection intervention in a community hospital setting. Using a pre-post study design, we compared the HAI rates of 5 multidrug-resistant bacteria (Acinetobacter baumannii, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Pseudomonas aeruginosa) from 6 culture sites before and after a 12-month facility-wide UV-C intervention. To measure impact of UV-C disinfection on hospital operations, mean inpatient emergency room wait time was calculated. Finally, we conducted a cost saving analysis to evaluate the financial benefits of the intervention. Overall, 245 HAIs among 13,177 inpatients were observed during a 12-month intervention period, with an incidence rate of 3.94 per 1,000 patient days. This observed HAIs incidence was 19.2% lower than the preintervention period (4.87 vs 3.94 per 1,000 patient days; P = .006). The intervention did not adversely impact emergency department admissions (297.9 vs 296.2 minutes; P = .18) and generated a direct cost savings of $1,219,878 over a 12-month period. The UV-C disinfection intervention was associated with a statistically significant facility-wide reduction of multidrug-resistant HAIs and generated substantial direct cost savings without adversely impacting hospital operations.