Kurin Lock for blood culture collection

Resource impact summary report

NICE has recommended that Kurin Lock can be used in the NHS to reduce contamination in blood culture collection in emergency departments with high blood culture contamination rates while more evidence is generated.

Kurin Lock is intended for use in secondary care, for people who have blood culture samples taken when bloodstream infections are suspected. Adopting Kurin Lock would need no change to standard practice. It has no additional staffing demands compared with standard care but some minimal training on the use of the device may be needed.

Current management involves cleaning the injection site with antiseptic, inserting a needle, and collecting blood directly into blood culture collection bottles.

There are around 16.7 million attendances in major A&E units in England (Hospital Accident & Emergency Activity, 2022-23 - NHS Digital). Blood culture contamination or false positive blood culture results can have detrimental effects on the patient and health service. This may have capacity implications through people having extended hospital stays, antibiotic exposure and diagnostic investigations.

Kurin Lock costs £19.50 per device and with 2 devices used per person, the total cost is £39 per test. Standard care devices cost £0.96 per person. Therefore, an additional cost of around £38 per person per test would be incurred when using a Kurin Lock device. However, bed day benefits may offset this cost. Bed savings may help patient flow and elective activity to be undertaken.

A resource impact template has been developed and published alongside this report. The template provides an illustration of the potential resource impact. It is based on an estimated 10,000 people having a blood culture test, of which 10% (1,000) are done using Kurin Lock. The table below shows the associated potential costs and savings from adopting Kurin Lock. The figures are based on the economic model evidence looking at 1 patient.

Table 1: Potential savings from using Kurin Lock compared with standard care in England

The saving is attributable to the bed days avoided based on a tariff cost of £692. The unit cost was based on the external assessment group (EAG) model. In practice, the bed day savings may be lower. Blood culture tests and antibiotic use are assumed to be covered by the tariff.

A bed day cost of around £316 would be needed in order for Kurin Lock to break even.

The capacity impacts are a result of a reduction in blood culture test contamination and the associated benefits such as:

These benefits may also provide some savings to offset some of the potential costs that may result from using Kurin lock compared with standard care.

The template helps organisations to assess costs and the associated capacity impacts from using Kurin Lock compared with standard care. Organisations can amend the template by inputting local data to estimate the resource impact at a local level.

Blood culture services are commissioned by integrated care boards. Providers are NHS hospital trusts and secondary care providers.

About this resource impact summary report

This resource impact summary report accompanies the NICE guidance on Kurin Lock for blood culture collection and should be read with it. See terms and conditions on the NICE website.

ISBN: 978-1-4731-6125-528