Trial reportAntimicrobial resistance and infection control2025
An economic evaluation of a hospital-wide bundle intervention to reduce hospital-acquired infections and bladder distension among hip fracture patients in Sweden.
Trial report in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02983136 (Safe Hands at the Sharp End- Implementing Aseptic Technique in the Operating Room, A Prospective Controlled Study With an Embedded Process Evaluation), which is not on this map. Cited by 1 paper.
What it found
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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.
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.
Safe Hands at the Sharp End- Implementing Aseptic Technique in the Operating Room, A Prospective Controlled Study With an Embedded Process Evaluation
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA theory-driven knowledge translation program was established to co-create and implement evidence-based practices to prevent urinary catheter-associated urinary tract infections (UC-UTIs) and bladder distension (BD). This study investigates the cost-effectiveness of implementing the Safe Hands and Safe Bladder bundle intervention compared to standard care for patients undergoing hip fracture surgery in Sweden.
methodThe study included outcomes from a quality register of patients who underwent hip fracture surgery at a Swedish hospital from 2015 to 2020. Adopting a healthcare perspective, estimates for the implementation cost were derived using activity-based costing, while the bundle's cost-effectiveness was estimated using a decision tree model. Health outcomes were evaluated based on adverse events, specifically UC-UTI and BD. Analyses included calculating the incremental cost-effectiveness ratio (ICER), which denotes the incremental cost per added infection rate expressed as a percentage. Additionally, sensitivity analyses were conducted to test the robustness of the results under alternative cost assumptions.
resultsThe likelihood of avoiding BD or UC-UTI increased from 50 to 87% over the course of the intervention year. The discounted implementation cost was SEK 890,389 (corresponding to Int$ 102,721). However, the implementation cost was offset by costs for a prolonged hospital stay due to these adverse events, resulting in an overall cost savings of SEK - 7,334 per patient (Int$ -846) in 2020 compared to before the intervention was introduced. Consequently, the intervention proved to be cost-effective, leading to savings and a decrease in the occurrence of adverse events.
conclusionImplementing the bundle intervention in units providing care for patients with acute hip fractures proved cost-effective. This offers decision makers valuable insights and demonstrates that implementation programs incorporating collaboration, facilitation and co-creation processes can effectively use limited resources. Further research should determine the generalizability of the findings to other settings and populations. CLINICALTRIALS: GOV REGISTRATION: NCT02983136 and ISRCTN 17,022,695, retrospectively registered after data collection were completed.
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