Effectiveness of measures to prevent needlestick injuries among ...

5 Cost effectiveness
the high HBV vaccination status of the HCW population (90 %) and that, in 90 % of
NSI cases, it was possible to determine the serological status of the source patient. The
authors further estimated the costs and benefits that would occur through the complete
substitution of safer devices for standard equipment at this hospital. They estimated the
incremental purchase costs of safer devices to be € 156,000 annually. Based on the
estimated average cost of NSI, a full year average number of NSI (N = 166), and
under the assumption of an 85 % reduction of NSI and that the reporting rate would
not change, the implementation would lead to a net benefit for the worker's accident
insurance of € 69,000 and to a net increase in costs for the hospital of € 135,000.
Overall net savings would, according to their model calculations, only have been
reached if the basic number of NSI was about 300, or twice the number observed.
A simple continuation of their model shows that the break-even point for this hospital
could not be reached (holding all other factors constant) below a basic number of
reported NSI of about 1,250. A further discussion and assessment of this study is not
possible because details were not yet published at the time of the preparation of this
report.
5.2.3 Intervention-based analysis
Several of the studies discussed or mentioned in the evaluation section also evaluated
the costs and benefits of their interventions. Theses studies are presented following
according to the categorization used in the previous chapter.
5.2.3.1 Replacement of hollow-bore needles
Orenstein et al. completed a twelve-month prospective evaluation in a 900-bed urban
hospital in the US in 1992 of the Becton-Dickinson 3 ml Safety-Lok syringe and of the
Baxter InterLink intravenous system. The direct costs of NSI were estimated at $ 260,
including testing and PEP, employee's lost time, and other health personnel time. The
purchase costs were ten times higher for the safer devices. After accounting for the
61 % reduction in NSI, a net increase in costs of $ 15,000 per half-year ($ 789 per
NSI prevented) was reported [33].
Report „Needlestick injuries“ 64