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Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection.

dc.contributor.author Cummings, KL
dc.contributor.author Anderson, DJ
dc.contributor.author Kaye, KS
dc.coverage.spatial United States
dc.date.accessioned 2011-06-21T17:27:18Z
dc.date.issued 2010-04
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/20184440
dc.identifier.uri https://hdl.handle.net/10161/4141
dc.description.abstract BACKGROUND: Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown. OBJECTIVE: To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthcare worker during patient care. DESIGN: Two models were created to simulate sequential patient contacts by a hand hygiene-noncompliant healthcare worker. Model 1 involved encounters with patients of unknown MRSA status. Model 2 involved an encounter with an MRSA-colonized patient followed by an encounter with a patient of unknown MRSA status. The probability of new MRSA infection for the second patient was calculated using published data. A simulation of 1 million noncompliant events was performed. Total costs of resulting infections were aggregated and amortized over all events. SETTING: Duke University Medical Center, a 750-bed tertiary medical center in Durham, North Carolina. RESULTS: Model 1 was associated with 42 MRSA infections (infection rate, 0.0042%). Mean infection cost was $47,092 (95% confidence interval [CI], $26,040-$68,146); mean cost per noncompliant event was $1.98 (95% CI, $0.91-$3.04). Model 2 was associated with 980 MRSA infections (0.098%). Mean infection cost was $53,598 (95% CI, $50,098-$57,097); mean cost per noncompliant event was $52.53 (95% CI, $47.73-$57.32). A 200-bed hospital incurs $1,779,283 in annual MRSA infection-related expenses attributable to hand hygiene noncompliance. A 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital. CONCLUSIONS: Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.
dc.language eng
dc.language.iso en_US
dc.relation.ispartof Infect Control Hosp Epidemiol
dc.relation.isversionof 10.1086/651096
dc.subject Academic Medical Centers
dc.subject Cross Infection
dc.subject Guideline Adherence
dc.subject Hand Disinfection
dc.subject Health Personnel
dc.subject Hospital Costs
dc.subject Humans
dc.subject Hygiene
dc.subject Infection Control
dc.subject Infectious Disease Transmission, Professional-to-Patient
dc.subject Methicillin-Resistant Staphylococcus aureus
dc.subject North Carolina
dc.subject Staphylococcal Infections
dc.title Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection.
dc.title.alternative
dc.type Journal article
dc.description.version Version of Record
duke.date.pubdate 2010-4-0
duke.description.issue 4
duke.description.volume 31
dc.relation.journal Infection Control and Hospital Epidemiology
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/20184440
pubs.begin-page 357
pubs.end-page 364
pubs.issue 4
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 31
dc.identifier.eissn 1559-6834


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