miércoles, 3 de junio de 2015

AHRQ's Healthcare-Associated Infections Program | Agency for Healthcare Research & Quality (AHRQ)

AHRQ's Healthcare-Associated Infections Program | Agency for Healthcare Research & Quality (AHRQ)

AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

AHRQ's Healthcare-Associated Infections Program

AHRQ plays a significant role in the national effort to reduce healthcare-associated infections (HAIs).

Healthcare-associated infections (HAIs) are among the leading threats to patient safety, affecting one out of every 25 hospital patients at any one time. Over a million HAIs occur across the U.S. health care system every year, leading to the loss of tens of thousands of lives and adding billions of dollars to health care costs. Fortunately, most HAIs are preventable.

AHRQ's HAI Program supports projects to advance the science of HAI prevention, develop more effective approaches for reducing HAIs, and help clinicians apply proven methods to prevent HAIs on the front lines of care. The projects funded by AHRQ's HAI Program accelerate the implementation of evidence-based methods to reduce HAIs in acute care hospitals and in ambulatory and long-term care settings, in accordance with the framework established by the Department of Health and Human Services' National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination.

The AHRQ HAl Program supports a robust portfolio of grants and contracts directed toward research on reducing HAIs and wide-scale implementation of proven methods to prevent these dangerous infections. AHRQ's projects focus on the applied end of the research continuum. These research projects generate evidence for developing and demonstrating effective interventions to reduce HAIs. The results of this research advance the ability of clinicians in the field to combat HAIs.

The free tools and resources noted below are derived from these research and implementation projects. Physicians, nurses, infection control, quality improvement, and other health care professionals can employ these tools in their facilities to prevent HAIs and keep patients safer in acute care hospitals, nursing homes and other long-term care settings, doctors' offices, ambulatory surgery centers, and end-stage renal disease facilities.

Tools & Resources to Prevent HAIs



The Comprehensive Unit-based Safety Program (CUSP) is an example of how AHRQ uses its HAl research dollars to develop proven methods to prevent HAIs and implement those methods on a large scale. CUSP combines techniques to improve safety culture, teamwork, and communications, together with a checklist of proven practices. CUSP can be applied to any safety problem, but it was first shown to be effective in reducing central line-associated bloodstream infections (CLABSIs) in 100 Michigan intensive care units and was then spread across the country. In that project, hospital ICUs reduced CLABSIs by 41 percent, preventing more than 2,100 infections, saving over 500 lives, and averting more than $36 million in excess costs. The CUSP Toolkit was developed based on this experience, allowing other hospitals to apply this proven method. More information about CUSP can be found at http://go.usa.gov/8bhB.

  • CUSP ToolkitThe CUSP Toolkit helps professionals and facilities apply CUSP to make health care safer. It includes checklists, PowerPoint slides, facilitator notes, instructional videos, education on the science of safety, and other resources. Created by clinicians for clinicians, the toolkit is modifiable to meet individual unit needs.
  • CLABSI ToolsThese tools were specifically developed to apply the CUSP framework to prevent CLABSIs.
  • Reducing CAUTI in Hospital PatientsThis ongoing project will result in resources to help clinicians and hospital staff reduce catheter-associated urinary tract infection (CAUTI) in hospital patients.
  • AHRQ Safety Program for SurgeryThis ongoing project will result in a toolkit for use in surgical units to improve safety culture and reduce surgical site infections and other complications. 
  • AHRQ Safety Program for Mechanically Ventilated PatientsThis ongoing project aims to make care safer for patients in intensive care units who require the assistance of a ventilator to breathe.
  • AHRQ Safety Program for Ambulatory SurgeryThis ongoing project will result in resources to reduce surgical site infections and other surgical complications within ambulatory surgery centers.
  • AHRQ Safety Program for Long-Term Care: Preventing CAUTI and Other HAIsThis ongoing project focuses on reducing catheter-associated urinary tract infection (CAUTI) and other HAIs in nursing homes and long-term-care facilities.
Universal ICU Decolonization: An Enhanced ProtocolThis online protocol provides instructions for implementing universal decolonization in adult ICUs, as was done in the REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs. Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus). The trial found that universal decolonization reduced bloodstream infections and the presence of MRSA (New England Journal of Medicine, May 29, 2013).

Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention ToolkitCarbapenem-resistant Enterobacteriaceae (CRE) refers to a family of bacteria that are difficult to treat because they have high levels of resistance to antibiotics. KPC (Klebsiella pneumoniae carbapenemase) is a highly dangerous type of CRE that has emerged as a major threat to patient safety because it is resistant to known treatments and kills more than half of patients who become infected with it. AHRQ, working with leading KPC researchers, developed a toolkit that hospitals can use to help control and prevent KPC outbreaks in their facilities.

Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial StewardshipThis online toolkit includes resources to help hospitals implement an antimicrobial stewardship program, or ASP, to specifically target C. difficile in their facility. The toolkit answers questions that hospitals commonly have when considering how to set up an ASP, such as “Is my organization ready?” and “How do I select the right intervention?” It is based on the Antimicrobial Stewardship Toolkit, which includes best practices from the Greater New York Hospital Association/United Hospital Fund Antimicrobial Stewardship Collaborative.

Reducing Infections in End-Stage Renal Disease (ESRD) FacilitiesThis ongoing project brings together subject matter experts and dialysis providers to develop a field-tested toolkit to help reduce HAIs in dialysis patients. The science-based and practical resources in the toolkit can be implemented by ESRD clinics. More information on the project, including early release tools, is available.


Synthesis: Results of AHRQ-funded HAI projectsAHRQ has commissioned a 3-year HAI Synthesis Project, which is reviewing and aggregating the findings and results of HAI research and implementation projects funded by AHRQ, primarily in the core period from fiscal years 2007 to 2010. The overall project will present important results for dissemination to the field and will report HAI knowledge gaps identified by project teams. The Synthesis Project includes four distinct pieces that together provide a unique perspective on the results of AHRQ-funded HAI projects.

Eliminating CLABSI, A National Patient Safety Imperative: Final ReportMore than 1,000 hospital units participating in this national implementation project used CUSP to reduce CLABSIs by 41 percent. Read the Companion Guide to the Final Report.

Eliminating CLABSI, A National Patient Safety Imperative: Neonatal CLABSI PreventionOne hundred neonatal intensive care units used CUSP to reduce CLABSIs by 58 percent.

Eliminating CAUTI: Interim Data ReportA July 2013 interim report from this ongoing project indicates that hospitals using CUSP were able to reduce CAUTI rates by 16 percent at 14 months post-baseline.

High-Performance Work Practices in CLABSI Prevention Interventions: Final Report, Executive Summary

This analysis of case studies developed from participants in AHRQ's CUSP national implementation project describes specific practices and "success factors" for reducing and eliminating CLABSIs in health care facilities.

Targeted versus Universal Decolonization to Prevent ICU Infection Link to Exit DisclaimerA peer-reviewed article appearing in the June 2013 issue of New England Journal of Medicine reports the results of the  REDUCE MRSA trial, a three-arm, cluster-randomized trial, to compare strategies for preventing ICU infections. The study was funded by AHRQ and conducted in collaboration with the Centers for Disease Control and Prevention. The trial found that universal decolonization was more effective than screening and isolation or screening and selective decolonization in reducing bloodstream infections and the presence of MRSA.

Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU: A Randomized Trial Link to Exit DisclaimerA peer-reviewed article appearing in the October 2013 issue of the Journal of the American Medical Association reports the result of an AHRQ-funded cluster-randomized trial in 20 medical and surgical ICUs in 20 hospitals. Researchers found that universal glove and gown use reduced the acquisition of MRSA but not vancomycin-resistant Enterococcus.

Clostridium difficile Infections: Diagnosis, Treatment, and PreventionThis summary for clinicians of a systematic review examined the comparative effectiveness of diagnostic tests, treatments, and prevention strategies for C. difficile infections in adults.
Page last reviewed May 2015
Internet Citation: AHRQ's Healthcare-Associated Infections Program: AHRQ plays a significant role in the national effort to reduce healthcare-associated infections (HAIs).. May 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/hais/index.html

No hay comentarios:

Publicar un comentario