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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Achieving zero: Central line BSIs on endangered list

The more some infection rates are driven down to absolute zero, the more disturbingly quaint appear all those old conversations about the inevitably of HAIs. The only thing inevitable about central line-associated bloodstream infections [CLABSIs] is that they are being driven to near extinction. Well, at least in the ICU.

The latest evidence comes from the Agency for Healthcare Research and Quality (AHRQ), which reports that ICUs in both large and small hospitals stopped CLABSIs for up to two years. They used a targeted quality improvement initiative known as the Comprehensive Unit-based Safety Program (CUSP) as part of the now famous Keystone Intensive Care Unit Project in Michigan hospitals. Joining other peer-reviewed reports on this effort is a new study , “The Ability of Intensive Care Units to Maintain Zero Central Line–Associated Bloodstream Infections” published in the current issue of the Archives of Internal Medicine.

Researchers found that 60% of the 80 ICUs evaluated went one year or more without an infection, and 26% achieved two years or more. Smaller hospitals sustained zero infections longer than larger hospitals, the researchers found.

“Previous research has shown that using CUSP to reduce healthcare-associated infections works,” said AHRQ Director Carolyn M. Clancy, M.D. “This study gives us even better news – that results from efforts to eliminate these deadly and costly infections can be sustained.”

The Keystone Project used a comprehensive approach that included promoting a culture of patient safety; improving communication among ICU staff teams; and using a checklist to promote implementation of practices based on guidelines from the CDC. AHRQ continues to support the nationwide implementation of CUSP through a contract with the Health Research & Educational Trust, an affiliate of the American Hospital Association, by reaching more hospitals and other settings in addition to ICUs and applying the approach to various HAIs.