In what it calls the largest national effort to stop central line-associated bloodstream infections (CLABSI), the Agency for Healthcare Research and Quality (AHRQ) cut infections by 40 percent in intensive care units in a four-year project that could become the national model for patient safety.
Partnered with the American Hospital Association (AHA) and Johns Hopkins Medicine, AHRQ used the Comprehensive Unit-based Safety Program (CUSP), which is a customizable program that focuses on unit-level attention to building patient care protocols.
"It is a really simple concept; trust the wisdom of your front-line clinicians," Peter J. Pronovost, Johns Hopkins senior vice president for patient safety and quality, patient safety advocate and creator of CUSP, said in an AHRQ statement yesterday.
Out of 1,100 adult ICUs in 44 states, infections dropped from 1.903 infections per 1,000 central-line days to 1.137 infections per 1,000 line days. The 40 percent reduction in CLABSIs saved more than 500 lives and more than $34 million in healthcare costs, AHRQ noted.
The study echoes earlier results from a statewide project using CUSP. The Kansas Healthcare Collaborative in July reported that Kansas hospitals successfully reduced CLABSIs by 79 percent over two years, with one hospital (Newton Medical Center's critical care unit) reporting CUSP brought infections down to zero.
"Historically, front line caregivers--especially nurses, have not been included in safety programs. But CUSP turns that model on its head," said Theresa Hickman, a nurse educator at Peterson Regional Medical Center in Kerrville, Texas, HealthLeaders Media reported.
The idea is that CUSP empowers the unit to make safety improvements. For instance, after nurses noted that the type on ampules that spelled out medication was too small (posing a potential safety risk), the hospital offered magnify glasses, Hickman said.
Healthcare-associated infections affect one in 20 hospital patients at any point in time, according to AHRQ.
For more information:
- see the AHRQ announcement and CUSP toolkit
- see the HealthLeaders article
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