Abstract
Background: Clostridium difficile infection is a serious hospital-acquired infection, causing negative outcomes for those who are afflicted by it. Hospital length of stay is known to be a risk factor for transmission and significant reductions in infection numbers can be realised if transmission is reduced.
Methods: A Markov model was constructed to compare the impact that five alternative healthcare scenarios had on total C. difficile infections, QALYs gained and total number of patients requiring treatment in ICU. A previously published stochastic transmission model for C. difficile informed scenario effectiveness, while other parameters were estimated from published literature, administrative datasets and expert opinion.
Results: Reducing inpatient LOS disrupts transmission of C. difficile and results in a large reduction of total infections. In turn, an increase in QALYs is expected when the number of infections is reduced. A reduction in infections reduces the number of ICU admissions, which is likely to have a large economic benefit in the Australian setting. Coupling a reduction in overall inpatient LOS with a ‘traditional’ infection control intervention, such as hand hygiene or antimicrobial stewardship, improves results further than reducing LOS on its own.
Conclusion: Implementing a LOS-focused intervention would be a practical challenge, especially for clinicians who already juggle high demand. However, it is not unattainable with the right local endorsement and could have significant benefits for health services.
Original language | English |
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Pages (from-to) | 87-92 |
Number of pages | 6 |
Journal | Infection, Disease and Health |
Volume | 23 |
Issue number | 2 |
Early online date | 26 Feb 2018 |
DOIs | |
Publication status | Published - Jun 2018 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2018 The Author(s)
Keywords
- CDI
- Clostridium difficile
- LOS
ASJC Scopus subject areas
- General Nursing
- Public Health, Environmental and Occupational Health
- Infectious Diseases