Publication Type:

Journal Article


International Journal for Quality in Health Care, Volume 24, Number 6, p.641-648 (2012)



adult, article, artificial ventilation, Cardiovascular Surgical Procedures, catheter, catheter associated urinary tract infection, catheter infection, Catheter-Related Infections, clinical practice, Continuing, continuing education, controlled study, Costs and Cost Analysis, Cross Infection, disinfection, Education, female, hand washing, health care cost, health care quality, health program, heart surgery, hospital infection, hospital readmission, Hospitals, human, Humans, infection control, Inservice Training, instrument sterilization, Intensive care units, length of stay, major clinical study, male, middle aged, mortality, online system, open heart surgery, outcome assessment, pneumonia, priority journal, prospective study, Resource allocation, risk reduction, surgical infection, surgical technique, surgical ward, Surgical Wound Infection, Teaching, Tertiary Care Centers, tertiary health care, university hospital, urinary tract infection, ventilator associated pneumonia, Ventilator-Associated


Objectives: To study the impact of modular training and implementation of infection control practices on all health-care-associated infections (HAIs) in a cardiac surgery (CVTS) program of a tertiary care hospital. Design: Baseline data were compared with post-intervention (with modular training) data. Settings: This study was conducted in a cardiovascular surgical unit. Participants: In total, 2838 patients were admitted in cardiovascular surgical service. Interventions: Two training modules and online continuous education were delivered to all health-care workers in CVTS unit. Main Outcome Measures: All four HAIs, such as surgical site infections (SSI), central line-associated blood stream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CA-UTI), were studied. Additional outcome measures included average length of stay cost of avoidance mortality and readmission rates. Results: The SSI rate had decreased in the post-intervention phase from 46 to 3.27% per 100 surgeries (P < 0.0001), CLABSI had decreased from 44 to 3.10% per 1000 catheter days (P < 0.009), VAP was reduced from 65 to 4.8% per 1000 ventilator days (P < 0.0001) and CA-UTI had reduced from 37 to 3.48% per 1000 urinary catheter days (P < 1.0). For every $1 spent on training, the return on investment was $236 as cost of avoidance of healthcare associated infections (HAIs). Conclusions: Standardization of infection control training and practices is the most cost-effective way to reduce HCAIs and related adverse outcomes. © The Author 2012. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.


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Cite this Research Publication

Sa Singh, Kumar, R. Ka, Sundaram, K. Ra, Kanjilal, Bb, and Nair, Pa, “Improving outcomes and reducing costs by modular training in infection control in a resource-limited setting”, International Journal for Quality in Health Care, vol. 24, pp. 641-648, 2012.