Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

Albert, Nancy M.; Slifcak, Ellen; Roach, Joel D.; Bena, James; Horvath, Gregory; Wilson, Sue; Bossche, Rosslyn Van Den; Vargas, Nemy; Rhoades, Victoria; Hartig, Katrina M.; Lachiewicz, Heather; Murray, Terri

doi:10.4037/ajcc2014362

Cited by 10 publications

(11 citation statements)

References 23 publications

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“… 21 Lower contamination rates are seen with spECG. 14 , 15 A United States (US) analysis of 27,000 CABG procedures found a 25% reduction in SSI following CABG in hospitals implementing spECG. 16 …”

Section: Introductionmentioning

confidence: 99%

“…12 Reports indicate that circa 3.6% of Australian CABG patients develop SWIs. 13 Several care improvement initiatives have been successful in reducing the rate of SWIs, [14][15][16] showing that the introduction of new medical technologies has the potential to eliminate a subset of avoidable infections. Key changes which have proven effective include the introduction of impregnated sutures, new wound dressings, and single-patient-use electrocardiograph (spECG) cable and lead systems.…”

Section: Introductionmentioning

confidence: 99%

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The Economic Implications of Introducing Single-Patient ECG Systems for Cardiac Surgery in Australia

Saunders¹,

Hedblom²

2021

CEOR

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Introduction Sternal wound infections (SWIs) are severe adverse events of cardiac surgery. This study aimed to estimate the economic burden of SWIs following coronary artery bypass grafts (CABG) in Australia. It also aimed to estimate the national and hospital cost-benefit of adopting single-patient electrocardiograph (spECG) systems for CABG monitoring, a measure that reduces the rate of surgical site infections (SSIs). Material and Methods A literature review, which focused on CABG-related SSIs, was conducted to identify data which were then used to adapt a published Markov cost-effectiveness model. The model adopted an Australian hospital perspective. Results The average SWI-related cost of care increase per patient was estimated at 1022 Australian dollars (AUD), and the annual burden to the Australian health care system at AUD 9.2 million. SWI burden comprised 360 additional intensive care unit (ICU) days; 1979 additional general ward (GW) days; and 186 readmissions. Implementing spECG resulted in 103 fewer ICU days, 565 fewer GW days, 48 avoided readmissions, and a total national cost saving of AUD 2.5 million, annually. A hospital performing 200 yearly CABGs was estimated to save AUD 54,830. Conclusion SWIs cause substantial costs to the Australian health care system. Implementing new technologies shown to reduce the SWI rate is likely to benefit patients and reduce costs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Economic Implications of Introducing Single-Patient ECG Systems for Cardiac Surgery in Australia

Saunders¹,

Hedblom²

2021

CEOR

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“…It was hypothesized that single-patient ECG leads and wires (spECG) would reduce the incidence of SSI by limiting the possibility of cross-contamination. Albert et al compared rECG and spECG, finding no difference in infections (not just SSI) acquired in the ICU, though noting that implementation of additional infection control measures drastically reduced HAI rates during the course of the study (15, 16). More recently, a Medicare claims analysis observing over 27,000 CABG surgeries found that facilities using spECG (Kendall™ DL, Cardinal Health, Dublin, OH) had a 25% reduction ( p > 0.05) in SSIs at 90 days post procedure (6).…”

Section: Introductionmentioning

confidence: 99%

The Cost Effectiveness of Single-Patient-Use Electrocardiograph Cable and Lead Systems in Monitoring for Coronary Artery Bypass Graft Surgery

Saunders

Lankiewicz

2019

Front. Cardiovasc. Med.

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Background: During admission for coronary artery bypass graft (CABG) surgery patients receive electrocardiograph (ECG) monitoring; for which reusable ECG cable and leads (rECG) are standard. Objective: Evaluate the cost effectiveness of a single-patient-use ECG cable and lead system (spECG). Methods: Review of the Medicare 2011–2014 database followed by a cost-effectiveness model considering a Medicare facility transitioning from rECG ($9 per patient) to spECG ($15). In-hospital ECG monitoring was for ≤8 days. In the model, patients underwent CABG and recovered in the intensive care unit, before transfer to the general ward and discharge. Surgical site infection (SSI) resulted in increased length of stay, readmission, or outpatient care. Health outcomes impacted EQ-5D-measured quality adjusted life years (QALYs). Health and cost outcomes were discounted at 3.5% annually. All costs in 2016 USD. Significance (95% level) was assessed via 2,000 simulations. Results: In 2014, 5.49% of patients had an SSI by 90-days post-surgery, with spECG reducing the odds of an SSI (odds ratio: 0.74, 0.62–0.89). Mean 40-year, per-patient costs to Medicare were $65,497 with rECG and $65,048 with spECG. The $450 saving was significant, with a median (95% credible interval) reduction of $466 ($174 to $989). Cost drivers were days required to treat inpatient SSIs. QALYs increases with spECG were significant but minor (median increase 0.008). Medicare savings may total $40 million per year with use of spECG. Conclusions: Post-operative SSI is a concern for Medicare patients undergoing CABG, and use of spECG is likely to provide cost and patient benefits.

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“…However, in the absence of clinical outcomes, this advice should be interpreted with caution. In a large randomized controlled trial encompassing more than 7200 patients, Albert and colleagues 85 could not demonstrate a difference in infection rate between ICU patients with disposable and reusable ECG lead wires.…”

Section: Infection Prevention and Controlmentioning

confidence: 99%

Recent Advances in Multidisciplinary Critical Care

Blot

Afonso

Labeau

2015

American Journal of Critical Care

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The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.

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Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

Cited by 10 publications

References 23 publications

The Economic Implications of Introducing Single-Patient ECG Systems for Cardiac Surgery in Australia

The Economic Implications of Introducing Single-Patient ECG Systems for Cardiac Surgery in Australia

The Cost Effectiveness of Single-Patient-Use Electrocardiograph Cable and Lead Systems in Monitoring for Coronary Artery Bypass Graft Surgery

Recent Advances in Multidisciplinary Critical Care

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