Effectiveness of measures to prevent needlestick injuries among ...

5 Cost effectiveness
5.2.3.2 Needleless IV systems
Gartner described the introduction of a needleless IV system in a 500-bed acute care
US hospital in 1990. The cost of a NSI was estimated at US $ 371 and included test-
ing, one HBV vaccine, lost employee working time and probably costs for health care
personnel involved in caring for injured HCW. The increase in the purchase price of
the new system was US $ 6,542 per half-year, only a 16 % increase over baseline. In
this report, there was a drastic reduction in equipment needs, since the new system
was largely reusable. The number of IV-related needlesticks decreased from 17 to 2
within a half-year after implementation, leading to savings of US $ 5,595. Therefore,
the new system led to a net increase of $ 94 per half-year [48]. Similar results, cost
savings through reduced tubing use, from about $ 10 per patient to $ 8 per patient
were reported by Skolnick et al., but the authors had no data related to costs of NSI
[58].
Fassel et al. reported direct costs for NSI of US $ 531 but provided no details as to
which costs were included in the calculation. The annual incremental costs of the new
system (Interlink) were $ 195,000 in 1992. If fully implemented (there was residual use
of conventional equipment during the observation period), savings would amount to
$ 42,000, leading to total incremental costs of about $ 153,000/year [56].
The cost-benefit analysis of Orenstein et al. has already been described, above,
together with the implementation of a safety syringe [33].
Yassi et al. evaluated the implementation of the InterLink System (Baxter) in a large
Canadian hospital in 1992/1993. The costs of NSI were estimated to range from CAN
$ 83 for a known seronegative source patient to CAN $ 559 for a known seropositive
source patient. Estimated costs included testing, PEP for HBV (no Zidovudine prophy-
laxis; no HCV testing) and lost work time of affected employees, health personnel
treating the injured HCW, and administrative costs. The incremental annual costs for
the needleless system were estimated to be about CAN $ 47,800, a 14 % increase.
The authors, like others above, also reported a decrease in the number of pieces of
equipment needed with the new system. There was an additional saving of 15 %
(CAN $ 13,200) from reduced disposal costs, because the new system is not classified
as sharps [54].
Report „Needlestick injuries“ 65