987. Cost Benefit Analysis of Hand Hygiene Program
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
  • LML Poster ID Week.pdf (1.5 MB)
  • Background: Singapore General Hospital, a 1600 bed acute tertiary care public hospital in Singapore, embarked on its vibrant hand hygiene program in 2007.  This was designed after the WHO’s recommended multimodal hand hygiene improvement strategy that comprises 5 key components: system change, training and education, evaluation and feedback, reminders in the workplace and institutional safety climate. 

    Methods: Hand hygiene compliance is monitored using the WHO audit tool in assessing compliance according to the 5 moments in various categories of healthcare workers in the inpatient setting.  Cost benefit analysis is done computing cost of program and net benefit gained using healthcare associated MRSA infections as an indicator.

    Results: We observed 22,904 opportunities for the period 2007 – 2010 and noted compliance to improve from 19.8 % in Jan 2007 to 51.1%, 57.6%, 65.6% and 61.2% in 2007, 2008, 2009 and 2010 respectively.  Improved compliances were also noted in all 5 moments and in all categories of healthcare workers over the years. This was closely related to increase in consumption of alcohol hand rub agents, 4% chlorhexidine, and normal soap hand wash agents from 35,531,550 ml (2007) to 42,755,900 ml (2009) and then 39,246,000 ml (2010).  The decline in 2010 was due to hospital-wide switch to using only alcohol hand rub as the cleaning agent for hands from 2009.  A decrease in healthcare associated MRSA infections was noted from 0.6 (2007) to 0.3 (2010) per 1,000 patient days (p value of 0.000001, Binomial test). The net benefit of the hand hygiene program was US$1,396,001.13 and the benefit-cost ratio was 13.4.

    Conclusion: The successful implementation of a hand hygiene program using the WHO improvement strategy reduces healthcare associated infections significantly and is cost-effective.

    Moi Lin Ling, MBBS, FRCPA, CPHQ, MBA, Infection Control, SINGAPORE GENERAL HOSPITAL, Singapore, Singapore, Jamie Tan, MBBS, Pathology, Singapore General Hospital, Singapore, Singapore and Kue Bien How, RN, BSc, CIC, Infection Control, Singapore General Hospital, Singapore, Singapore


    M. L. Ling, None

    J. Tan, None

    K. B. How, None

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