To optimize infection-control practices, know your providers’ priorities

Demonstrated cost-effectiveness is a highly motivating factor in getting healthcare workers to adopt measures for preventing and controlling healthcare-associated infections.

Much less important is how long it takes—and by extension how much of a bother it is—to implement the measures. 

So report researchers at Duke-NUS Medical School in Singapore April 15 in JAMA Network Open. 

For the study, Shalini Elangovan, PhD, and colleagues surveyed more than 250 healthcare professionals from around the world. 

All respondents were authors or co-authors of published research in one or more of 10 peer-reviewed journals focused on infection prevention and control. 

Noting that a majority of respondents, 63%, lived and worked in high-income countries, Elangovan and co-authors report a consistent preference for several aspects of infection-busting practices across geographies. 

“Economic costs and benefits were consistently the most important attribute across all regions, with marked regional variation in secondary priorities,” the authors write.

Along with positive cost-effectiveness profiles, the widely persuasive factors include strong clinical evidence, short implementation durations and low time burdens. 

‘Latent’ classes of healthcare workers emerge 

Elangovan and co-researchers also identified two latent classes of healthcare workers who tend to champion anti-infection measures. These are: 

• Evidence seekers in low- and middle-income countries who prioritize high-quality evidence while also showing high willingness to adopt practices, and 
   
• Efficiency seekers, including respondents from high-income countries, who are more selective and prioritize cost-effectiveness. 

Elangovan and co-authors cite prior research showing rates of healthcare-associated infections vary by world region. They note estimates of 11.2% in the Eastern Mediterranean, 9.0% in Southeast Asia, 6.5% in Europe and 3.2% in the Americas.

The team noted variances in infection-control practices persisting across income levels and geographic regions. 

These variances, the authors remark, “reflect the need for further research to better understand contextual factors influencing infection prevention and control decision-making, particularly in low- and middle-income settings.”

Economic evidence spurs sustainable adoption 

Sustainable adoption might be broadened through the promotion of solid economic evidence and tailored implementation support, they add. 

Suggesting their findings might help refine infection-control practices, Elangovan and co-authors offer: 

Efficiency seekers valued both cost-effectiveness and the time required for healthcare professionals to carry out infection prevention and control (IPC) actions. This suggests that, among respondents from high-income countries, efficiency of IPC practices is a key driver of adoption. These findings can inform the design of IPC practices in high-income settings by emphasizing efficiency to support implementation. 

The study is posted in full for free.