Assignment: Absenteeism Productivity losses
Herzer, Niessen, Constenla, Ward, and Pronovost (2014) listed the cost of education as $3,579 of total pro- gram ($192,292) on central line-associated bloodstream infections prevention. The total initiative was a multiface- ted quality improvement program in ICUs reporting employee education as only a small part of efforts. The ba- sis of the initiative was to examine the cost-effectiveness of the Keystone ICU project (Waters et al., 2011) using hospi- tal data and nationally representative data sources. We excluded this study because the NPD economic impact was difficult to sort out from the impact of the other inter- ventions. The estimate of costs for education of clinicians was very low, creating questions about how itwas calculated.
Quinn et al. (2014) reported a cost avoidance of $1.6 million from nonventilator hospital-acquired pneumonia as a result of implementing oral nursing care. However, the cost andmethodsof educating thenurseswasnot described in the article; therefore, it was not included in the synthesis.
Finally, Simmons et al. (2017) studied trainingnonnursing staff to provide caloric supplementation for nutritionally at-risk nursing home residents. These authors concluded that it is cost-effective to train nonnurses to provide caloric supplementation, and the practice had a positive effect on the residents’ intake. This was excluded from our synthesis because the method of calculating the costs of training was unclear and the participantswere largely nonprofessionals, adding questions regarding correlation to NPD.
KNOWN COSTS OF OUTCOMES TABLE The original Known Costs of Outcomes Table published in 2016 (Opperman et al., 2016b)made it easier forNPDprac- titioners to identify the financial value of improved outcomes and calculate economic impact. In particular,
Journal for Nurses in Professional Development www.jnpdonline.com 305
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TABLE 2 Updated Known Costs of Outcomes Table 2018 Conditions Recent Cost Estimate References Absenteeism Productivity losses due to absenteeism:
$1,685 per employee annually Stinson (2015)
Adverse drug events Estimated extra cost per case in 2015: $5,746 AHRQ (2017)
Asthma Asthma/COPD treatment
Chronic disease managementV complications and hospitalizations
Self-management education and home-based interventions
$539 annual mean cost of outpatient visits $16,600 annual mean cost of inpatient visits $1,164 annual mean cost of ED visits $690 annual mean medication cost Average per child expenditure for treatment of asthma: $690 Cost savings from fewer ED visits/ hospitalizations resulted in ROI of 1.33; add benefits due to reduced missed school days and missed work days, the societal ROI increased to 1.85 Review of 26 intensive outpatient asthma self-management education and home visit programs 20 had greater than $1 ROI per $1 invested; 3 had less than $1 ROI per $1 invested; 3 were variable
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