AHRQ's Healthcare-Associated Infections Program

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.

AHRQ’s HAI program funds work to help frontline clinicians and other health care staff prevent HAIs by improving how care is actually delivered to patients. This work is accomplished through a robust portfolio of grants and contracts that focus on applied research – or research that advances the ability of clinicians in the field to combat HAIs. This kind of research brings knowledge to the front lines of care faster by helping clinicians and staff better understand how to apply proven methods of making care safer. AHRQ funds both research and implementation projects that:

Advance the science of HAI prevention.
Develop more effective approaches for reducing HAIs, and
Help clinicians apply proven methods to prevent HAIs.

AHRQ conducts its HAI program in accordance with the framework established by the Department of Health and Human Services' (HHS) National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination and the research agenda of the Combating Antibiotic Resistant Bacteria Action Plan. Background about the HHS role in developing the Action Plan is available at https://www.hhs.gov/ash/advisory-committees/paccarb/index.html.

These publicly-available tools and resources are based on AHRQ's research.

Tools & Resources to Prevent HAIs

Tools

CUSP

The Comprehensive Unit-based Safety Program (CUSP) combines techniques to improve safety culture, teamwork, and communications, together with a checklist of proven practices. The Core CUSP Toolkit was developed based on the experiences of more than 1000 ICUs that reduced central line-associated blood stream infections by 41 percent. More information about CUSP can be found at http://go.usa.gov/8bhB.

Core CUSP Toolkit
The Core CUSP Toolkit helps clinical teams develop a basic understanding of how to apply the CUSP method to make health care safer. Topic-specific toolkits provide additional resources that can help clinician teams address targeted safety issues within the CUSP framework.
Toolkit for Reducing CLABSI in Hospitals
These tools were specifically developed to apply the CUSP method to prevent CLABSIs.
Toolkit for Reducing CAUTI in Hospitals
This toolkit helps hospital units teach team members how to adopt and sustain best practices to improve safety culture and reduce CAUTI.
Toolkit To Improve Safety For Mechanically Ventilated Patients
This toolkit helps hospitals make care safer for mechanically ventilated patients in intensive care units.
AHRQ Safety Program for Surgery
This is an ongoing project that will generate a toolkit to help surgical units improve safety culture and reduce surgical site infections and other complications.
Toolkit To Improve Safety in Ambulatory Surgery Centers
This toolkit helps ambulatory surgery centers reduce surgical site infections and other complications.
Toolkit To Reduce CAUTI and Other HAIs in Long-Term Care Facilities
This toolkit helps nursing homes and long-term-care facilities reduce catheter-associated urinary tract infection (CAUTI) and other HAIs.
AHRQ Safety Program for Improving Surgical Care and Recovery
This ongoing implementation project aims to help hospitals and clinicians use the CUSP method to enhance the surgical process and improve patients' recovery after surgery.
AHRQ Safety Program for Improving Antibiotic Use
This is an ongoing project to improve the use of antibiotics in a variety of health care settings by applying the CUSP method.
AHRQ Safety Program for Intensive Care Units: Preventing CLABSI and CAUTI
This is an ongoing project is to reduce the rate of central line-associated blood stream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) in hospital intensive care units (ICUs) with elevated rates of these infections.

Universal ICU Decolonization: An Enhanced Protocol

This protocol provides instructions for implementing universal decolonization in adult ICUs, as was done in the REDUCE MRSA Trial (New England Journal of Medicine, May 29, 2013).

Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit

This toolkit helps hospitals address breaks of Carbapenem-resistant Enterobacteriaceae (CRE), a family of bacteria that have high levels of resistance to antibiotics. It includes resources on KPC (Klebsiella pneumoniae carbapenemase), a potentially lethal type of CRE.

Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial Stewardship

This practical toolkit helps hospitals implement an antimicrobial stewardship program that specifically targets C. difficile. It answers common questions such as “Is my organization ready?” and “How do I select the right intervention?”

Reducing Infections in End-Stage Renal Disease (ESRD) Facilities

This field-tested toolkit helps dialysis centers apply proven methods to reduce HAIs in this vulnerable patient population.

Nursing Home Antimicrobial Stewardship Guide

This guide includes several toolkits and step-by-step guidance to help nursing homes implement an antibiotic stewardship program, determine if it’s necessary to treat a resident with antibiotics, help clinicians select the right antibiotic, and engage residents and families in infection prevention.

Central Line Insertion Care Team Checklist

This checklist provides sequential critical steps that have shown to reduce central line-associated infections.

Resources

Synthesis: Results of AHRQ-funded HAI projects

Results of a three-year project to review and aggregate the findings and results of AHRQ's HAI research and implementation projects that were funded primarily in the core period from fiscal years 2007 to 2010.

Eliminating CLABSI, A National Patient Safety Imperative: Final Report

Find out how a national implementation project involving more than 1,000 hospital units 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 Prevention

Find out how one hundred neonatal intensive care units used CUSP to reduce CLABSIs by 58 percent.

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

This analysis of case studies describes specific practices and "success factors" for reducing and eliminating CLABSIs in health care facilities.

Eliminating CAUTI: Interim Data Report

This July 2013 interim report indicates that hospitals using CUSP were able to reduce CAUTI rates by 16 percent at 14 months post-baseline.

Targeted versus Universal Decolonization to Prevent ICU Infection

A June 2013 New England Journal of Medicine article reports the results of the REDUCE MRSA trial. This three-arm, cluster-randomized trial compared three strategies for preventing ICU infections and found universal decolonization to be the most effective.

Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU: A Randomized Trial

An October 2013 Journal of the American Medical Association article reports the result of a cluster-randomized trial in 20 medical and surgical ICUs in 20 hospitals that found universal glove and gown use reduced the acquisition of MRSA but not vancomycin-resistant Enterococcus.

Clostridium difficile Infections: Diagnosis, Treatment, and Prevention

This systematic review examines the comparative effectiveness of diagnostic tests, treatments, and prevention strategies for C. difficile infections in adults.

Page last reviewed June 2017
Page originally created September 2014

Internet Citation: AHRQ's Healthcare-Associated Infections Program. Content last reviewed June 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/hais/index.html