Centre of Research Excellence in Reducing Healthcare Associated Infections

The Centre of Research Excellence in Reducing Healthcare Associated Infections (CRE-RHAI) ran from 2012-2017, funded by the National Health and Medical Research Council (NHMRC; Grant 1030103). Led by AusHSI’s Professor Nicholas Graves, the CRE-RHAI aimed to research the control and prevention of healthcare infections from an economic and health services perspective. The work of the CRE-RHAI can be broadly defined into three key research themes – health economics, health policy, and health system research. By bringing together researchers with interest across these themes, and applying their expertise to the study of healthcare infections, we were able to generate powerful and useful information to inform the development of health policy and practice.

 

Under the academic leadership of Professor Nick Graves, the funding from the NHMRC enabled us to support a group of excellent researchers and students as they developed their skills and careers to become independent researchers, building capacity in Australia’s health research community. We’ve collaborated closely with stakeholders and other key researchers in infection prevention and control to create a strong body of evidence to drive change in policy and practice. What we hope now is that the recommendations arising from our team’s work will be used to drive real changes in policy and practice, and to focus future research endeavours.  A plain language (lay summary) description of the outcomes of key projects of the CRE-RHAI is available for download here.

If you require any further information about the CRE-RHAI, or any of the individual projects conducted through the CRE-RHAI, please email contact@aushsi.org.au

Outcomes

Plain Language summary booklet

To ensure our research outcomes are accessible to a wide range of audiences and not restricted to academic publications, the CRE-RHAI team prepared a plain language summary of a number of key research projects. The summary booklet can be downloaded as a pdf document here

Infection, Disease and Health Special Issue

In 2018, the Infection, Disease & Health journal published an online special issue with selected outcomes from the CRE-RHAI. This special issue is open access and can be viewed here.

Investigators

The eight Chief Investigators of the CRE-RHAI, based at Australian and International universities, brought together expertise in health economics, statistics and mathematical modelling, health policy, infectious diseases, microbiology, epidemiology and general practice. The key role of the Chief Investigator team was in achieving the successful funding grant from the NHMRC, and establishing the early priority areas for the CRE-RHAI. A number of Chief Investigators also directly supervised PhD students and had input on shaping specific research projects.

  • Professor Nicholas Graves
    Academic Director
    Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology
  • Professor David Paterson
    Director, UQ Centre for Clinical Research (UQCCR), University of Queensland
  • Professor Thomas Riley
    Professor of Pathology and Laboratory Medicine, University of Western Australia
  • Professor Graeme Nimmo
    State Director of Microbiology, Pathology Queensland, Queensland Health
  • Professor Ben Cooper
    Mahidol Oxford Tropical Research Unit (MORU), Thailand
  • Professor Andrew Wilson
    Co-Director, Menzies Centre for Health Policy, University of Sydney
  • Professor Jenny Doust
    Professor, Centre for Research in Evidence-Based Practice, Bond University
  • Professor Martin Wolkewitz
    Professor, University of Freiburg, Germany

Partners

The CRE-RHAI worked closely with government agencies and professional bodies in infection control, and collaborated with industry partners on specific events or projects. Key stakeholder partners of the CRE-RHAI were:

Australian Commission on Safety and Quality in Health Care

We worked with the ACSQHC to put cost-effectiveness information about infection control on the agenda of policy makers. Our research will help hospitals meet ACSQHC accreditation standard 3 (Preventing and Controlling Healthcare Associated Infections) in the most cost-effective manner possible.

Australasian College for Infection Prevention and Control

We worked with the ACIPC to disseminate research findings to our clinical stakeholders and to consult and engage with infection control practitioners through the College’s wide networks.

Outcomes

Peer-review journal publications

  1. Allen, M., L. Hall, K. Halton, and N. Graves, Improving hospital environmental hygiene with the use of a targeted multi-modal bundle strategy.Infection, Disease and Health, 2018. 23(2): p. 107-13.
  2. Brain, D., L. Yakob, A. Barnett, T. Riley, A. Clements, K. Halton, and N. Graves, Economic evaluation of interventions designed to reduce Clostridium difficile infection.PLoS ONE, 2018. 13(1).
  3. Brain, D.C., A.G. Barnett, L. Yakob, A. Clements, T.V. Riley, K. Halton, and N. Graves, Reducing length of stay to improve Clostridium difficile-related health outcomes.Infection, Disease and Health, 2018. 23(2): p. 87-92.
  4. Graves, N., The Centre of Research Excellence in Reducing Healthcare Associated Infections.Infection, Disease and Health, 2018. 23(3):p. 125-126.
  5. Lee, X.J., A.N. Pettitt, and S.J. Dancer, Quantifying the relative effect of environmental contamination on surgical ward MRSA incidence: An exploratory analysis.Infection, Disease & Health, 2018.
  6. Lum, E.P.M., K. Page, J.A. Whitty, J. Doust, and N. Graves, Antibiotic prescribing in primary healthcare: Dominant factors and trade-offs in decision-making.Infection, Disease and Health, 2018. 23(2): p. 74-86.
  7. Martin, E., M. Beckmann, L. Barnsbee, K. Halton, K. Merollini, and N. Graves, Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: A systematic review of reviews and meta-analyses.BJOG: An International Journal of Obstetrics and Gynaecology, 2018. 125(8): p. 956-64.
  8. Wozniak, T.M., Clinical management of drug-resistant bacteria in Australian hospitals: An online survey of doctors’ opinions.Infection, Disease & Health, 2018. 23(1): p. 41-48.
  9. Wozniak, T.M., N. Graves, and A.G. Barnett, How much do superbugs cost Australian hospitals? An evidence-based open-access tool.Infection, Disease & Health, 2018. 23(1): p. 54-6.
  10. Coulter, S., J.A. Roberts, K. Hajkowicz, and K. Halton, The Use of Bloodstream Infection Mortality to Measure the Impact of Antimicrobial Stewardship Interventions: Assessing the Evidence.Infect Dis Rep, 2017. 9(1): p. 6849.
  11. Halton, K., L. Hall, A. Gardner, D. MacBeth, and B.G. Mitchell, Exploring the context for effective clinical governance in infection control.Am J Infect Control, 2017. 45(3): p. 278-283.
  12. Havers, S.M., P.L. Russo, K. Page, A. Wilson, and L. Hall, Aseptic technique and the implementation of national policy: Contextual factors for consideration.Infection, Disease & Health, 2017. 22(2): p. 94-95.
  13. Lee, X.J., G.R. Fulford, A.N. Pettitt, and F. Ruggeri, A stochastic model for MRSA transmission within a hospital ward incorporating environmental contamination.Epidemiol Infect, 2017. 145(4): p. 825-838.
  14. Lum, E.P.M., K. Page, L. Nissen, J. Doust, and N. Graves, Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice.BMC Public Health, 2017. 17(1): p. 799.
  15. Mitchell, B.G., D. MacBeth, K. Halton, A. Gardner, and L. Hall, Resourcing hospital infection prevention and control units in Australia: A discussion paper.Infection, Disease & Health, 2017. 22(2): p. 83-88.
  16. Page, K., A.G. Barnett, and N. Graves, What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.BMC Health Serv Res, 2017. 17(1): p. 137.
  17. Russo, P.L., A.C. Cheng, B.G. Mitchell, and L. Hall, Healthcare-associated infections in Australia: tackling the ‘known unknowns’.Australian Health Review, 2017. 42: p. 178-180.
  18. Wozniak, T.M., D. Paterson, and K. Halton, Review of the epidemiological data regarding antimicrobial resistance in Gram-negative bacteria in Australia.Infection, Disease & Health, 2017. 22(4): p. 210-218.
  19. Graves, N., C. Wloch, J. Wilson, A. Barnett, A. Sutton, N. Cooper, K. Merollini, V. McCreanor, Q. Cheng, E. Burn, T. Lamagni, and A. Charlett, A cost-effectiveness modelling study of strategies to reduce risk of infection following primary hip replacement based on a systematic review.Health Technol Assess, 2016. 20(54): p. 1-144.
  20. Merlo, G., N. Graves, D. Brain, and L. Connelly, Economic Evaluation of Fecal Microbiota Transplantation for the Treatment of Recurrent Clostridium Difficile Infection in Australia.J Gastroenterol Hepatol, 2016. 31(12): p. 1927-32.
  21. Russo, P.L., G. Chen, A.C. Cheng, M. Richards, N. Graves, J. Ratcliffe, and L. Hall, Novel application of a discrete choice experiment to identify preferences for a national healthcare-associated infection surveillance programme: a cross-sectional study.BMJ Open, 2016. 6(5): p. e011397.
  22. Russo, P.L., S.M. Havers, A.C. Cheng, M. Richards, N. Graves, and L. Hall, Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.Am J Infect Control, 2016. 44(12): p. 1505-1510.
  23. Coulter, S., K. Merollini, J.A. Roberts, N. Graves, and K. Halton, The need for cost-effectiveness analyses of antimicrobial stewardship programmes: A structured review.International Journal of Antimicrobial Agents, 2015. 46(2): p. 140-149.
  24. Hall, L., K. Halton, D. Macbeth, A. Gardner, and B. Mitchell, Roles, responsibilities and scope of practice: describing the ‘state of play’ for infection control professionals in Australia and New Zealand.Healthcare infection, 2015. 20(1): p. 29-35.
  25. Havers, S.M., P.L. Russo, B. Mitchell, and L. Hall, Health-care-associated infections.The Lancet Infectious Diseases, 2015. 15(7): p. 763-764.
  26. Lee, X.J., C.C. Drovandi, and A.N. Pettitt, Model choice problems using approximate Bayesian computation with applications to pathogen transmission data sets.Biometrics, 2015. 71(1): p. 198-207.
  27. Martin, E., Rationing in Healthcare. 2015, Deeble Insitute – Issues Brief: Canberra.
  28. Merlo, G., K. Page, J. Ratcliffe, K. Halton, and N. Graves, Bridging the Gap: Exploring the Barriers to Using Economic Evidence in Healthcare Decision Making and Strategies for Improving Uptake.Applied Health Economics and Health Policy, 2015. 13(3): p. 303-309.
  29. Mitchell, B.G., L. Hall, K. Halton, D. MacBeth, and A. Gardner, Infection control standards and credentialing.Am J Infect Control, 2015. 43(12): p. 1380-1.
  30. Mitchell, B.G., L. Hall, D. MacBeth, A. Gardner, and K. Halton, Hospital infection control units: staffing, costs, and priorities.Am J Infect Control, 2015. 43(6): p. 612-6.
  31. Russo, P.L., A.G. Barnett, A.C. Cheng, M. Richards, N. Graves, and L. Hall, Differences in identifying healthcare associated infections using clinical vignettes and the influence of respondent characteristics: A cross-sectional survey of Australian infection prevention staff.Antimicrobial Resistance and Infection Control, 2015. 4(1).
  32. Russo, P.L., A.C. Cheng, M. Richards, N. Graves, and L. Hall, Variation in health care-associated infection surveillance practices in Australia.American Journal of Infection Control, 2015. 43(7): p. 773-775.
  33. Russo, P.L., A.C. Cheng, M. Richards, N. Graves, and L. Hall, Healthcare-associated infections in Australia: Time for national surveillance.Australian Health Review, 2015. 39(1): p. 37-43.
  34. Allen, M., K. Halton, L. Hall, E. Bailey, and N. Graves, Preventing infections through cleaner hospitals project.Aust Nurs Midwifery J, 2014. 22(3): p. 32.
  35. Avent, M.L., L. Hall, L. Davis, M. Allen, J.A. Roberts, S. Unwin, K.A. McIntosh, K. Thursky, K. Buising, and D.L. Paterson, Antimicrobial stewardship activities: A survey of Queensland hospitals.Australian Health Review, 2014. 38(5): p. 557-563.
  36. Cooper, K., G. Frampton, P. Harris, J. Jones, T. Cooper, N. Graves, J. Cleland, J. Shepherd, A. Clegg, and B.H. Cuthbertson, Are educational interventions to prevent catheter-related bloodstream infections in intensive care unit cost-effective?J Hosp Infect, 2014. 86(1): p. 47-52.
  37. Graves, N., The economics of UTI surveillance.Healthcare Infection, 2014. 19(1): p. 37.
  38. Graves, N., How costs change with infection prevention efforts.Curr Opin Infect Dis, 2014. 27(4): p. 390-3.
  39. Halton, K., N. Graves, and L. Hall,Opportunity cost of unavailable surgical instruments in Australian hospitals.ANZ J Surg, 2014. 84(12): p. 905-6.
  40. Martin, E., Preventing infections following caesarean section.Aust Nurs Midwifery J, 2014. 22(3): p. 37.
  41. Mitchell, B.G., A. Gardner, A.G. Barnett, J.E. Hiller, and N. Graves, The prolongation of length of stay because of Clostridium difficile infection.Am J Infect Control, 2014. 42(2): p. 164-7.
  42. Zheng, H., A.G. Barnett, K. Merollini, A. Sutton, N. Cooper, T. Berendt, J. Wilson, and N. Graves, Control strategies to prevent total hip replacement-related infections: a systematic review and mixed treatment comparison.BMJ open, 2014. 4(3): p. e003978.
  43. Hall, L., K. Halton, E.J. Bailey, K. Page, M. Whitby, D.L. Paterson, and N. Graves, Post-discharge surgical site surveillance – where to from here?J Hosp Infect, 2013. 84(3): p. 268.
  44. Merollini, K.M.D., R.W. Crawford, and N. Graves, Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia: A retrospective analysis.BMC Health Services Research, 2013. 13(1).
  45. Merollini, K.M.D., R.W. Crawford, S.L. Whitehouse, and N. Graves, Surgical site infection prevention following total hip arthroplasty in Australia: A cost-effectiveness analysis.American Journal of Infection Control, 2013. 41(9): p. 803-809.
  46. Merollini, K.M.D., H. Zheng, and N. Graves, Most relevant strategies for preventing surgical site infection after total hip arthroplasty: Guideline recommendations and expert opinion.American Journal of Infection Control, 2013. 41(3): p. 221-226.
  47. Mitchell, B.G., S.J. Dancer, R.Z. Shaban, and N. Graves, Moving forward with hospital cleaning.American Journal of Infection Control, 2013. 41(11): p. 1138-1139.
  48. Page, K., N. Graves, K. Halton, and A.G. Barnett, Humans, ‘things’ and space: Costing hospital infection control interventions.Journal of Hospital Infection, 2013. 84(3): p. 200-205.
  49. Page, K., N. Graves, K. Halton, E.J. Bailey, G.R. Fulford, and M. Whitby, Key priorities for Australian infection control: Summary of findings from the launch of the Centre for Research Excellence in Reducing Healthcare Associated Infections.Healthcare Infection, 2012. 17(4): p. 133-135.

PhD Theses (available on QUT eprints)

  1. Allen, Michelle. (2016) Preventing infections through cleaner hospitals (PITCH)- A novel targeted hospital environmental hygiene bundle. PhD thesis, Queensland University of Technology
  2. Russo, Philip L.(2016) Evidence based recommendations for national healthcare-associated infection surveillance. PhD by Publication, Queensland University of Technology.
  3. Brain, David C.(2016) An economic evaluation of healthcare interventions designed to reduce Clostridium difficile infection. PhD thesis, Queensland University of Technology.
  4. Lum, Elaine P.(2017) Making decisions about antibiotic use in the Australian primary healthcare sector. PhD thesis, Queensland University of Technology.
  5. Lee, Xing Ju(2017) Statistical and simulation modelling for enhanced understanding of hospital pathogen and related health issues. PhD by Publication, Queensland University of Technology.
  6. Merlo, Gregory B.(2017) “Going over the parapet”: The development of a framework for understanding the translation of evidence from economic evaluations. PhD thesis, Queensland University of Technology.
  7. Martin, Elizabeth Kate(2017) A cost-effectiveness modelling study of strategies to prevent post-caesarian surgical site infection. PhD thesis, Queensland University of Technology.
  8. Coulter, Sonali A.(2018) An economic evaluation of antimicrobial stewardship programs in metropolitan Australian hospitals. PhD thesis, Queensland University of Technology.

Disclaimer

The CRE-RHAI was funded by a Centres of Research Excellence grant from the NHMRC (GNT 1030103). Information presented here is solely the responsibility of the Administering Institution of the grant (QUT) and is not endorsed by, or representative of the views of the views of, the NHMRC.