Ultraviolet-C-based sanitization is a cost-effective option for hospitals to manage health care-associated infection risks from high touch mobile phones

Abstract

Mobile phones have become essential tools for health care workers around the world, but as high touch surfaces, they can harbor microorganisms that pose infection risks to patients and staff. As their use in hospitals increases, hospital managers must introduce measures to sanitize mobile phones and reduce risks of health care-associated infections. But such measures can involve substantial costs. Our objective in this paper was to consider two mobile phone risk mitigation strategies that managers of a hypothetical hospital could implement and determine which involves the lowest cost. The first strategy required all staff to sanitize their hands after every contact with a mobile phone. The second involved the hospital investing in ultraviolet-C-based mobile phone sanitization devices that allowed staff to decontaminate their mobile phones after every use. We assessed each intervention on material and opportunity costs assuming both achieved an equivalent reduction in microbe transmission within the hospital. We found that ultraviolet-C devices were the most cost-effective intervention, with median costs of approximately AUD360 per bed per year compared to AUD965 using hand hygiene protocols. Our results imply that a 200-bed hospital could potentially save AUD1-1.4 million over 10 years by investing in germicidal ultraviolet-C phone sanitizers rather than relying solely on hand hygiene protocols.

Keywords: antimicrobial; cost effectiveness analysis; fomite; hand hygiene; hospital-acquired infections; mobile phone sanitizer; public health; ultraviolet-C.

Figure 1

Cost effectiveness of interventions to minimize health care-associated infection risks due to mobile phones. Panels A and B show the present value of costs incurred by the hospital using hand sanitization protocols and ultraviolet-C sanitization devices, respectively. The plots indicate the 5th, 25th, median, 75th and 95th percentiles and simulation data are superimposed. By year 10, the hospital is likely to have outlaid $1.7–2.2 million (5th–75th percentiles) in material and opportunity costs by adopting hand sanitization protocols (panel A), and $0.6–0.8 million by adopting ultraviolet-C sanitation devices (panel B). This is equivalent to $850–1,100 per bed per year and $300–400 per bed per year, respectively.

Figure 2

Net present value accruing to the hospital over a 10-year planning horizon if ultraviolet-C sanitization devices are used to minimize health care-associated infection risks due to mobile phones. The plots indicate the 5th, 25th, median, 75th and 95th percentiles. By year 10, results show that the hospital is likely to have gained $1.0–1.4 million (5th–75th percentiles) due to avoided costs related to hand hygiene practices, which is equivalent to $500–700 per bed per year.

Figure 3

Sensitivity of net present value results to changes in parameter values. Parameters are ranked from top to bottom according to the sensitivity of the net present value over 10 years to changes in each, with the length of the bars corresponding to each parameter reflecting the change in results produced. Each parameter specified as a distribution (indicated by *) was changed to the minimum and maximum values of its range while all other parameters remained unchanged, and the resultant net present value recorded. Parameters specified as fixed values were changed by ±25%. The net present value was most sensitive to changes in the wage rate, healthcare worker-to-patient ratio, the number of beds in the hospital and the number of ultraviolet-C devices per bed.