Evidence map›Paper›PMID 40208588›Full record

Trial reportJAMA network open2025

Economic Evaluation of Enhanced Cleaning and Disinfection of Shared Medical Equipment.

David Brain, Nirmali Sivapragasam, Katrina Browne, Nicole M White, Philip L Russo, Allen C Cheng, Andrew J Stewardson, Georgia Matterson, Peta E Tehan, Kirsty Graham and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Clean Hospitals Day 2025: the human factors of healthcare environmental hygiene.Antimicrobial resistance and infection control · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

David BrainAustralian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Nirmali SivapragasamAustralian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Katrina BrowneSchool of Nursing and Health, Avondale University, Wahroonga, New South Wales, Australia.
Nicole M WhiteAustralian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Philip L RussoSchool of Nursing and Health, Avondale University, Wahroonga, New South Wales, Australia.
Allen C ChengInfectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Andrew J StewardsonDepartment of Infectious Diseases, The Alfred and School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Georgia MattersonSchool of Nursing and Health, Avondale University, Wahroonga, New South Wales, Australia.
Peta E TehanSchool of Nursing and Health, Avondale University, Wahroonga, New South Wales, Australia.
Kirsty GrahamCentral Coast Local Health District, Gosford, New South Wales, Australia.
Maham AminCentral Coast Local Health District, Gosford, New South Wales, Australia.
Martin KiernanSchool of Nursing and Health, Avondale University, Wahroonga, New South Wales, Australia.
Jennie KingCentral Coast Local Health District, Gosford, New South Wales, Australia.
Brett G MitchellCentral Coast Local Health District, Gosford, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The economic value of cleaning and disinfection of shared medical equipment is currently unknown. Objective: To evaluate whether or not better environmental cleaning and disinfection of shared medical equipment would be cost-effective compared with usual care. Design, Setting, and Participants: This economic evaluation study was a within-trial cost-effectiveness analysis of a stepped-wedge cluster randomized clinical trial: the Cleaning and Enhanced Disinfection (CLEEN) study. The trial included 5002 inpatients and was conducted in 10 adult acute-care wards at a tertiary hospital in Australia between March 20, 2023, and November 24, 2023. The evaluation takes a hospital costing perspective. A decision-tree model was developed to evaluate the intervention; costs are presented in Australian dollars. Statistical analysis was performed from May to October 2024. Interventions: A multimodal cleaning intervention was introduced during the intervention, focusing on additional cleaning hours, education, audit, and feedback. The control group received usual care, including routine cleaning by clinical staff. Main Outcomes and Measures: Incremental cost-effectiveness ratio, where the mean change to costs associated with the intervention is divided by the mean change in outcomes. Results: This study assessed 5002 patients (2478 [49.5%] male, 2524 [50.5%] female [50.5%]; mean [SD] age, 71.6 [16.1] years). For a cohort of 1000 patients at risk of health care-associated infection (HAI), the estimated total costs associated with the intervention were $1 513 300, compared with $2 155 310 for usual care. The estimated number of HAIs was 100 in the intervention group, compared with 130 for the usual care group. Compared with usual care, the intervention was associated with reduced HAIs and costs, with a 90.5% chance that intervention adoption was cost-saving. This probability increased to 99.9% if a decision-maker was willing to pay $20 000 to avoid an infection. Conclusions and Relevance: In this economic evaluation study of enhanced cleaning and disinfection of shared medical equipment, the intervention resulted in reduced HAIs and a $642 010 reduction in costs per 1000 patients, compared with the control group. These results suggest that the CLEEN intervention is a cost-saving initiative.

Indexed as

Cross InfectionDisinfectionInfection ControlAgedAged, 80 and overAustraliaCost-Benefit AnalysisFemaleHumansMaleMiddle AgedTertiary Care Centers

Identifiers

PMID40208588
PMCPMC11986775

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.