Kristen Miller1, Carol Briody2, Donna Casey3, Jill K Kane4, Dannette Mitchell5, Badrish Patel4, Carol Ritter4, Maureen Seckel4, Sandy Wakai6, Marci Drees7. 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.
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.
Authors: Ladjane Santos Wolmer de Melo; Maria Verônica Monteiro de Abreu; Bernuarda Roberta de Oliveira Santos; Maria das Graças Washington Casimiro Carreteiro; Maria Fernanda Aparecida Moura de Souza; Maria Carolina Andrade Lins de Albuquerque; Claudia Fernanda de Lacerda Vidal; Heloisa Ramos Lacerda Journal: BMC Infect Dis Date: 2021-02-25 Impact factor: 3.090
Authors: Morgan J Katz; Pranita D Tamma; Sara E Cosgrove; Melissa A Miller; Prashila Dullabh; Therese A Rowe; Roy Ahn; Kathleen Speck; Yue Gao; Savyasachi Shah; Robin L P Jump Journal: JAMA Netw Open Date: 2022-02-01