Using the Comprehensive Unit-based Safety Program model for sustained reduction in hospital infections - 31/08/16

Doi : 10.1016/j.ajic.2016.02.038

Kristen Miller, DrPh, MSPH ^a,^* , Carol Briody, MT (ASCP), CIC ^b, Donna Casey, BSN, MA, RN, FABC, NE-BC ^c, Jill K. Kane, BSN, RN, CCRN ^d, Dannette Mitchell, MSN, APRN, ACNS-BC, CCRN ^e, Badrish Patel, MD ^d, Carol Ritter, MSN, RN, CCRN, CNML ^d, Maureen Seckel, APN, MSN, ACNS-BC, CCNS, FCCM ^d, Sandy Wakai, MSN, RN, CCRN ^f, Marci Drees, MD, MS ^a,^b
^a Value Institute, Christiana Care Health System, Newark, DE
^b Infection Prevention, Christiana Care Health System, Newark, DE
^c Patient Care Services, Cardiovascular and Critical Care, Christiana Care Health System, Newark, DE
^d Medical ICU, Christiana Care Health System, Newark, DE
^e Medical ICU, Wilmington Hospital, Wilmington, DE
^f Joint Replace Center, Wilmington Hospital, Wilmington, DE

^*Address correspondence to: Kristen Miller, DrPh, MSPH, Value Institute, Christiana Care Health System, John H. Ammon Medical Education Center, 4755 Ogletown-Stanton Rd, 2nd FL, Office 2E61C, Newark, DE 19718. (K. Miller).Value InstituteChristiana Care Health SystemJohn H. Ammon Medical Education Center, 4755 Ogletown-Stanton Rd, 2nd FL, Office 2E61CNewarkDE19718

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.

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Key Words : Comprehensive Unit–based Safety Program, catheter infections, bloodstream infections, safety culture

Plan

Conflicts of Interest: None to report.

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Vol 44 - N° 9

P. 969-976 - septembre 2016 Retour au numéro

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Using the Comprehensive Unit-based Safety Program model for sustained reduction in hospital infections - 31/08/16

Abstract

Background

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