The Agency for Healthcare Research and Quality (AHRQ) recently awarded $34 million to expand the fight against healthcare-associated infections (HAIs). These infections affect patients in all health care settings including, at any one point in time, 1 in 20 patients in hospitals. These projects and others funded by the Agency help to attain the goals of the Department of Health and Human Services' (HHS) Partnership for Patients initiative, a nationwide public-private partnership that aims to make care safer for patients and reduce unnecessary return visits to the hospital, while making care less costly.
"Infections are not an inevitable consequence of health care; they are preventable," said AHRQ Director Carolyn Clancy, M.D. "With this investment, we are building on proven strategies to give doctors and health care teams the help they need to ensure that patients are safe from infections."
These awards include projects to develop, test, and spread the use of new modules of the Comprehensive Unit-based Safety Program (CUSP), a proven method to prevent and reduce HAIs. Since 2008, AHRQ has been promoting the nationwide adoption of CUSP to reduce central line-associated blood stream infections (CLABSIs). The new modules target three additional infections that are also areas of focus for the Partnership for Patients:
- Catheter-associated urinary tract infections, the most common HAI, which can occur in patients with urinary catheters.
- Surgical site infections, a complication of surgery that can occur at the incision site or deeper within the body.
- Ventilator-associated pneumonia, which can occur in patients who require mechanically assisted breathing and, as a result, have a higher risk of developing health care-associated pneumonia.
CUSP is a multipronged program that promotes a culture of patient safety; improved communication and teamwork among unit staff members; and the use of tools, including checklists, to support implementation of evidence-based practices for HAI prevention, such as hand washing and removing unnecessary catheters. A recent report from the ongoing AHRQ-funded project that is implementing CUSP to reduce CLABSIs found that these infections were reduced by an average of 33 percent.
The report is online at Eliminating CLABSI: A National Patient Safety Imperative
. AHRQ is continuing to fund this project to reduce CLABSIs, which is also an area of focus for the Partnership for Patients.
Other newly funded projects include research on ways of reducing infections with methicillin-resistant Staphylococcus aureus (MRSA), a bacterium that is resistant to certain antibiotics, and Clostridium difficile, an organism that often affects patients on prolonged antibiotic treatment; the use of health care facility design to reduce HAIs; and alignment of work system factors to maximize and sustain successful HAI reduction efforts. A novel 36-month project will synthesize the results of AHRQ-funded HAI projects in fiscal years 2007-2010 to identify and promote the application of effective HAI prevention approaches and identify gaps in the HAI science base that can be filled with additional research. AHRQ is also continuing to fund research on HAIs in long-term care, dialysis facilities, and ambulatory care. A complete list of the projects funded in Fiscal Year 2011 can be found at: AHRQ Projects to Prevent Healthcare-Associated Infections, Fiscal Year 2011
AHRQ has funded research to fight HAIs since 2003. The Agency's ongoing work helps attain the goals of the Partnership for Patients, a national, public-private partnership of hospitals, employers, physicians, nurses, consumers, State and Federal governments, and other key stakeholders. More information on the Partnership for Patients is available at http://partnershipforpatients.cms.gov/.
The fiscal year 2011 AHRQ-funded projects also contribute to implementing the strategies outlined in the HHS Action Plan to Prevent Healthcare-Associated Infections (www.hhs.gov/ash/initiatives/hai/index.html), which is aligned with the goals of the Partnership for Patients. Together, these HHS initiatives represent a broad partnership of Federal entities aiming for the common goal of improving health care, including the Administration on Aging, AHRQ, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, Department of Defense, Food and Drug Administration, Health Resources and Services Administration, Indian Health Service, the National Institutes of Health, and others.