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Am J Infect Control. 2016 Sep 1;44(9):969-76. doi: 10.1016/j.ajic.2016.02.038. Epub 2016 May 13.

Using the Comprehensive Unit-based Safety Program model for sustained reduction in hospital infections.

Author information

1
Value Institute, Christiana Care Health System, Newark, DE. Electronic address: Krmiller@christianacare.org.
2
Infection Prevention, Christiana Care Health System, Newark, DE.
3
Patient Care Services, Cardiovascular and Critical Care, Christiana Care Health System, Newark, DE.
4
Medical ICU, Christiana Care Health System, Newark, DE.
5
Medical ICU, Wilmington Hospital, Wilmington, DE.
6
Joint Replace Center, Wilmington Hospital, Wilmington, DE.
7
Value Institute, Christiana Care Health System, Newark, DE; Infection Prevention, Christiana Care Health System, Newark, DE.

Abstract

BACKGROUND:

Prompted by the high number of central line-associated bloodstream infections (CLABSIs), our institution joined the national On the CUSP: Stop BSI initiative. We not only report the significant impact that the Comprehensive Unit-based Safety Program (CUSP) had in reducing CLABSI, but also report catheter-associated urinary tract infections (CAUTIs) and ventilator-associated pneumonia (VAP) in 2 intensive care units (ICUs).

METHODS:

At our community-based academic health care system, 2 ICUs implemented CUSP tools and developed local interventions to reduce CLABSI and other safety problems. We measured CLABSI, CAUTI, and VAP during baseline, the CUSP period, and a post-CUSP period.

RESULTS:

CLABSIs decreased from 3.9 per 1,000 catheter days at baseline to 1.2 during the CUSP period to 0.6 during the post-CUSP period (rate ratio, 0.16; 95% confidence interval [CI], 0.07-0.35). CAUTIs decreased from 2.4 per 1,000 patient days to 1.2 during the post-CUSP period (rate ratio, 0.4; 95% CI, 0.24-0.65). VAP rate decreased from 2.7 per 1,000 ventilator days to 1.6 during the CUSP and post-CUSP periods (rate ratio, 0.58; 95% CI, 0.30-1.10). Device utilization decreased significantly in both ICUs.

CONCLUSIONS:

Implementation of CUSP was associated with significant decreases in CLABSI, CAUTI, and VAP. The CUSP model, allowing for implementation of evidence-based practices and engagement of frontline staff, creates sustainable improvements that reach far beyond the initial targeted problem.

KEYWORDS:

Comprehensive Unit–based Safety Program; bloodstream infections; catheter infections; safety culture

PMID:
27184208
DOI:
10.1016/j.ajic.2016.02.038
[Indexed for MEDLINE]

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