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Nationwide program slashes CLABSI rate in ICUs


A nationwide patient safety project reduced the rate of central line-associated bloodstream infections in ICUs by 40%, according to preliminary findings.

The Agency for Healthcare Research and Quality, which supplied funding, called the project the largest national effort to date to reduce CLABSIs. Through the program, clinicians prevented more than 2,000 CLABSIs, saved more than 500 lives and avoided more than $34 million in healthcare costs, according to a news release.

Hospital teams at more than 1,100 ICUs in 44 states participated in the project over a four-year period. Participating hospitals reduced the rate of CLABSIs nationally from 1,903 infections to 1,137 infections per 1,000 central line days, for an overall reduction of 40%, according to the preliminary findings.

The project used the Comprehensive Unit-based Safety Program, a customizable program that helps hospital units address the foundation of how clinical teams care for patients. It combines clinical best practices with an understanding of the science of safety, improved safety culture and an increased focus on teamwork, according to the news release.

Based on the experiences gained in this project, the CUSP toolkit helps nurses, physicians and other members of the clinical team understand how to identify safety problems and gives them the tools to tackle these problems. It includes teaching tools and resources to support implementation at the unit level.

The first broad-scale application of CUSP was in Michigan, under the leadership of the Michigan Health & Hospital Association, where it was used to significantly reduce CLABSIs in that state. It was expanded to 10 states and then nationally through an AHRQ contract to the Health Research & Educational Trust, the research arm of the American Hospital Association.

CUSP was created by a team led by Peter J. Pronovost, MD, PhD, senior vice president for patient safety and quality at Johns Hopkins Medicine. Pronovost described CUSP as “a really simple concept: Trust the wisdom of your front-line clinicians.”

Details about AHRQ’s national CUSP project are available at, and the CUSP toolkit is available at

CUSP builds on work led by the Centers for Disease Control and Prevention and its evidence-based recommendations on treating infections. Together with the National Action Plan to Prevent Healthcare Associated Infections ( and the Partnership for Patients (, AHRQ’s efforts are a part of a coordinated approach drawing on expertise across the U.S. Department of Health and Human Services.


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