Evaluating the cost-effectiveness of strategies to prevent vascular access device infections

The evidence clearly indicates that a care-bundle approach is needed to prevent catheter-related bloodstream infections (CRBSIs). Such an approach includes the need for education, training and adequate staffing, sterile barrier precautions, skin preparation, use of intravenous dressings and antimicrobial prophylaxis. Care bundles advise which aspects must be given priority and what procedures will produce optimum outcomes. All of these activities come at a cost, yet very few studies have investigated the extent to which they are cost-effective. As a result, it is difficult to make evidence-based decisions on the potential cost savings that may be achieved with a care-bundle approach. This article describes the existing health-economic evidence on strategies to prevent CRBSIs and outlines the criteria for future research.