Quality push curbs infections in neonatal ICUs: AHRQ

A group of 100 hospital neonatal intensive-care units participating in a government-funded quality initiative made big strides in reducing rates of central line-associated bloodstream infections, according to data from HHS' Agency for Healthcare Research and Quality.

The NICUs, located in nine states, were part of an AHRQ-funded initiative known as On the CUSP: Stop BSI, which relies on the Comprehensive Unit-Based Safety Protocol, or CUSP.

CUSP is a multipronged strategy that emphasizes teamwork, culture change and the use of a simple checklist of evidence-based practices. Developed by Dr. Peter Pronovost, now the head of the Armstrong Institute for Patient Safety at Johns Hopkins University, Baltimore, and used in a well-known project that virtually eliminated central line infections in 100 Michigan ICUs, the CUSP program has been used by hospitals across the country to drive improvement. In 2009, AHRQ funded a 50-state roll-out of CUSP.

The NICUs in the most recently released data saw their overall rate of central line-associated bloodstream infections drop 58%, from 2.043 infections per 1,000 line days at the baseline to 0.855 infections per 1,000 line days 11 months later. That decrease prevented 131 infections and as many as 41 deaths and avoided more than $2 million in additional healthcare costs, according to AHRQ estimates.

“The CUSP framework brings together safety culture, teamwork and best practices—a combination that is clearly working to keep these vulnerable babies safer,” said Dr. Carolyn Clancy, AHRQ's director, in a news release. “These remarkable results show us that, with the right tools and dedicated clinicians, hospital units can rapidly make care safer.”

On the CUSP: Stop BSI, which ended in September 2012, was credited with a 41% reduction in central line infections among more than 1,000 participating hospitals, according to final data released in October.