ECONI

Project Team

Chief Investigator: Professor Jacqui Reilly

GCU Co-investigators: Dr Helen Mason (Yunus Centre)

External Collaborators: Professor Chris Robertson (University of Strathclyde), Professor Nick Graves (Queensland University of Technology)

GCU researchers funded by study: Sally Stewart (Research Project Manager), Dr Sarkis Manoukian (Research Fellow Yunus Centre), Lynne Haahr (Administrator/Data Manager)

Funder: NHS Health Protection Scotland

Dates: Completed

Background

Healthcare associated infections (HAIs) or Nosocomial Infections (NI) are infection acquired as a result of an episode of healthcare. HAIs are distressing for patients, increase their length of stay and incur additional costs to both the patient and the healthcare system. Studies which assess the impact of HAI tend to focus on the impact on patients in terms of morbidity and mortality within hospital. Point prevalence surveys of HAI are undertaken every five years throughout Europe. In Scotland on any one day during 2016 one in every twenty-two patients in hospital had an active HAI. While prevalence of HAI is an effective measure of burden of disease and proportion of infection types and is an essential measure when planning resources, in order to develop a full picture of risk and impact data on the incidence of HAI is survey was necessary

Aim

This study investigated the cost and impact of Healthcare Associated Infection (HAI) to patients, the health service and the wider community. This was in order to develop a model to allow policy makers to compare the cost effectiveness of Infection Prevention and Control measures in NHS Scotland.

Objectives

The study had four objectives

Determine the incidence and type of HAI in hospital.
To estimate the impact of HAI on patient care in hospital.
To investigate the impact of HAI on patient care post discharge
To develop a framework to support decision-making for future investment in Infection Prevention and Control (IPC)

Study design

ECONI was a two-centre, observational incidence study with record linkage there is a nested case-control and qualitative study. The case-control study component included a longitudinal follow-up for one year post-discharge. A qualitative study undertook interviews with a selected group of patients who acquired HAI during their hospital stay.

Publications

Manoukian S, Stewart S, Dancer S, Graves N, Mason H, McFarland A, Robertson C, Reilly J. Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology. J Hosp Infect. 2018 100(2):222-235. doi: 10.1016/j.jhin.2018.06.003

Stewart, S., Robertson, C., Manoukian, S., Haahr, L., Mason, H., McFarland, A., Dancer, S., Cook, B., Reilly, J., Graves, N., & ECONI Steering Committee (2019). How do we evaluate the cost of nosocomial infection? The ECONI protocol: an incidence study with nested case-control evaluating cost and quality of life. BMJ open, 9(6) https://doi.org/10.1136/bmjopen-2018-026687

S. Stewart, C. Robertson, J. Pan, S. Kennedy, S. Dancer, L. Haahr, S. Manoukian, H. Mason, K. Kavanagh, B. Cook, J. Reilly Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: considerations for infection prevention and control planning. Journal of Hospital Infection 14 (2021) 10-22 https://doi.org/10.1016/j.jhin.2021.03.031.

S. Stewart, C. Robertson, J. Pan, S. Kennedy, L. Haahr, S. Manoukian, H. Mason, K. Kavanagh, N. Graves, S.J. Dancer, B. Cook, J. Reilly Impact of healthcare-associated infection on length of stay Journal of Hospital Infection 114 (2021) 23-31 https://doi.org/10.1016/j.jhin.2021.02.026.

S. Stewart, C. Robertson, S. Kennedy, K. Kavanagh, L. Haahr, S. Manoukian, H. Mason, S. Dancer, B. Cook, J. Reilly Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection Journal of Hospital Infection 114 (2021) 32-42 https://doi.org/10.1016/j.jhin.2021.03.032.

S. Manoukian, S. Stewart, N. Graves, H. Mason, C. Robertson, S. Kennedy, J. Pan, K. Kavanagh, L. Haahr, M. Adil, S.J. Dancer, B. Cook, J. Reilly Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK Journal of Hospital Infection 114 (2021) 43-50 https://doi.org/10.1016/j.jhin.2020.12.027.

S. Manoukian, S. Stewart, N. Graves, H. Mason, C. Robertson, S. Kennedy, J. Pan, L. Haahr, S.J. Dancer, B. Cook, J. Reilly Evaluating the post-discharge cost of healthcare-associated infection in NHS Scotland Journal of Hospital Infection 114 (2021) 51-58 https://doi.org/10.1016/j.jhin.2020.12.026.