Poster can be found in location 101.

Background: Preventing adverse events in healthcare, including hospital-acquired infections, is crucial and requires effective evidence-based care. To address this challenge, a strategy directed to implement improved hand hygiene and aseptic techniques in the care process of hip fracture patients was adopted, building on person-centred ethics. Through co-creation, leaders and staff developed a bundle intervention including two different sub-interventions; Safe Hands and Safe Bladder, focusing on reducing urinary catheter-associated urinary tract infection (UC-UTI) and bladder distension (BD), respectively. This study aimed to estimate the cost-effectiveness of this implementation program (including the bundle intervention) compared to standard care in this patient group. Method: A before/after study included patients undergoing hip fracture surgery in a Swedish hospital during 2015 (before) to 2020 (after). A decision tree model was used to estimate implementation costs and cost-effectiveness of the bundle, adopting a healthcare perspective. Health outcomes were frequency of adverse events, i.e., UC-UTI and BD. Analyses included calculating the incremental cost-effectiveness ration (ICER) indicating the additional cost per percentage reduction in infection, and sensitivity analyses to test its robustness. Results: The bundle intervention increased the likelihood of not getting infected from 50% to 87%. The discounted implementation cost was SEK 890,389.  However, the implementation was offset by costs for prolonged hospital stay due to adverse events, resulting in cost savings of SEK -7,333.64 per patient in 2020 compared to before the project was conducted. The intervention was thus cost-effective, resulting in both cost savings and reduced adverse events frequency. Conclusion: The implementation program (including the bundle intervention) was cost-effective among hip fracture patients in this hospital. Although further research should explore if the findings are generalizable to other settings, it offers decision-makers insights that implementation programs with co-creation processes can result in effective use of resources. Trial registration ID: NCT029831336 and ID: ISRCTN 17022695.