Turning Your Product Evaluation into a Publication
Over the last two decades, heightened attention to patient safety and the prevention of healthcare-associated infections (HAIs) has led to infection prevention professionals being inundated with products and innovative technologies targeting the prevention and control of these infections. The increasing portfolio of industry offerings has coincided with supply chain cost containment initiatives within healthcare organizations.
Infection preventionists (IPs), who are members on Product Standardization/Evaluation committees, are instrumental in introducing and evaluating these products and technologies. However, as the majority of these newer products may be more expensive than historical products, a cost benefit analysis is frequently requested before the purchase will be approved. These analyses represent quasi-experimental studies that warrant dissemination through professional meetings and publication.
Product Evaluation to Publication
Valenti and Herwaldt1 defined steps of product evaluation which included identification of product priorities based on the facility’s HAI rates, a review of data regarding the product or similar products, planning a trial period for the product in the appropriate clinical settings to determine product performance and analysis of the trial period results. In this process, the product serves as the intervention and quasi-experimental studies are used to evaluate the association between a non-randomized intervention and an outcome.2 Prospective quasi-experimental designs for product evaluation may use historical control data or a stronger design which includes a concurrent control group. Using an example of a product evaluation aimed at reducing S. aureus bloodstream infections (BSIs) among ICU patients, we can examine each of these designs.
- The problem: High rates of aureus BSIs among ICU patients despite the use of a nasal and body decolonization protocol for all patients.
- Conduct literature review: The facility IP conducts a literature review of decolonization protocols used for ICU patients and finds encouraging data for a new product “X”.
- Research question: Will using product “X” as a nasal decolonization agent reduce aureus BSIs among ICU patients?
- Research proposal: 1) Recruitment of 2 ICUs for trialing the new product using historical aureus BSI control data or 2) 2 ICUs trial the new product “X” and 2 ICUs continue to use the current product and serve as the concurrent control group.
- Define study timeframe: Trial using product “X” instead of the historical product for 6 months.
- Methods: BSI surveillance data is collected using the same methodology as during the pre-intervention period and 1) is compared to the previous BSI rates from the study units or 2) is compared to the BSI rates in the intervention units with the control units.
- Results: Analysis of findings which ideally will include a return on investment (ROI) calculation using published or institutional data on the cost savings associated with BSI reduction. Zimlichman and colleagues3 estimated the attributable costs of BSIs associated with central venous catheterization at nearly $50,000 and $59,000 for methicillin-resistant aureus. Using this economic data, a ROI calculation can be made based on the number of BSIs that were avoided by use of the intervention product.
- Conclusion(s): Discuss implications of adoption – implementation science.
This product evaluation process mirrors the elements required for development of an abstract and/or a publication in a professional journal: background/literature, research methods (data collection/data analysis), results, discussion, and conclusion.
As professionals, we have an obligation to share our knowledge with our constituents and this includes product evaluation. You have done the work, so get writing!
1Valenti WM and Herwaldt LA. Product evaluation. Infect Control Hosp Epidemiol 1997;18:722-727.
2Schweizer M, Braun BI, Milstone AM. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship—Quasi-Experimental Designs. Infect Control Hosp Epidemiol 2016;37(10):1135-1140.
3Zimlichman E, Henderson D, Tamir O, et al. Health Care–Associated Infections: A Meta-analysis of Costs and Financial Impact on the US Health Care System. JAMA Int Med September 2, 2013:E1-E8.