WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

<strong>WHO</strong> GUIDELINES ON HAND HYGIENE IN HEALTH CARE
Case-study:
England and Wales national programme, a programme
with potential benefits
National programmes can achieve economies of scale in
terms of the production and distribution of materials. In
England and Wales, the NPSA “cleanyourhands” campaign
is a collaboration between national government bodies
and the commercial sector in the development, piloting,
evaluation, and implementation of the programme. The
national procurement body for the National Health Service
(NHS) and the national NHS Logistics Authority, which
has expertise in distributing products across the NHS,
have worked in partnership with the NPSA to ensure the
campaign achieves its objectives. The Logistics Authority
is responsible for the distribution of the alcohol-based
handrubs and the campaign materials to every hospital
implementing the campaign.
The NPSA campaign is funded centrally for its first year;
thereafter, all campaign materials will be produced and
funded by commercial companies on the national alcoholbased
handrub contract. The companies will fund this by
paying a licence fee in proportion to their turnover on the
contract.
At the outset, the six main sources of possible financial
benefits to the wider health-care economy resulting from a
successful campaign were identified as those relating to:
• reduced hospital costs;
• reduced primary care costs;
• reduced costs incurred by patients;
• reduced costs of informal carers;
• productivity gains in the wider economy;
• reduced costs associated with litigation and
compensation.
Though there are some up-front costs for hospitals
associated with implementing the campaign, for a 500-
bed hospital it would cost around UK£ 3000 initially to
put alcohol-based handrub at each bedside. The analysis
suggested that the campaign would deliver net savings
from the outset. An Excel spreadsheet for self-completion
by an individual health-care institution has been produced,
which allows for the input of local data and will indicate
likely cost savings over time (Appendix 4). Even if financial
savings were not to be realized, the likely patient benefits
in terms of lives saved and relatively modest costs mean
that the intervention would still be highly cost effective
compared with many other NHS activities. The economic
evaluation went on to suggest that the campaign would
be cost saving even if the reduction in hospital-acquired
infection rates were as low as 0.1%.
Table III.3.1
Costs of the most common health care-associated infections in the USA
Type of infection Attributable costs in US$ Range
Mean Standard deviation Minimum Maximum
Bloodstream infection 36 441 37 078 1 822 107 156
Surgical site infection 25 546 39 875 1 783 134 602
Ventilator-associated pneumonia 9 969 2 920 7 904 12 034
Urinary tract infection 1 006 503 650 1 361
Reproduced from Cosgrove SE & Perencevich EN with permission from Lippincott Williams & Wilkins. 1056
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