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Implementing Strategies to Prevent Infections in Acute-Care Settings

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7 Table 4. Comprehensive Unit-based Safety Program (CUSP) (cont'd) Settings that have applied the CUSP framework: • Intensive care units (ICUs) 7 • Ambulatory settings (primary care, ambulatory surgery centers 6 • Nursing homes 9 • Additional clinical settings with mixed results 10 Improvements using CUSP: • Antibiotic overprescribing in primary care 5 • CLABSI prevention 7,13 • CAUTI prevention 2,8 ▶ AHA/HRET Eliminating CAUTI (Stop CAUTI) 12 1. Pronovost, P, Weast, B, Rosenstein, B. Implementing and validating a comprehensive unit-based safety program. J Pat Saf Infect Control 2005;1:33–40. 2. Pronovost, P, Needham, D, Berenholtz, S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355:2725–2732. 3. The CUSP Toolkit 2018. Agency for Healthcare Research and Quality website. https://www. ahrq.gov/hai/cusp/index.html. 4. Meddings, J, Chopra, V, Saint, S. Preventing Hospital Infections: Real-World Problems, Realistic Solutions. New York: Oxford University Press; 2021. 5. Keller, SC, Caballero, TM, Tamma, PD, et al. Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality safety program for improving antibiotic use and the COVID-19 pandemic. JAMA Netw Open 2022;5:e2220512. 6. Tool kit to improve safety in ambulatory surgery centers. Agency for Healthcare Research and Quality website. https://www.ahrq.gov/hai/tools/ambulatory-surgery/index.html. 7. Miller, K, Briody, C, Casey, D, et al. Using the Comprehensive Unit-based Safety Program model for sustained reduction in hospital infections. Am J Infect Control 2016;44:969–976. 8. Saint, S, Greene, MT, Krein, SL, et al. A program to prevent catheter-associated urinary tract infection in acute care. N Engl J Med 2016;374:2111–2119. 9. Mody, L, Greene, MT, Meddings, J, et al. A national implementation project to prevent catheter- associated urinary tract infection in nursing home residents. JAMA Intern Med 2017;177:1154– 1162. 10. The National Academies Press. Peer review of a report on strategies to improve patient safety, 2021. https://www.nap.edu/read/26136/chapter/4#16. 11. The CUSP Toolkit 2018. Agency for Healthcare Research and Quality website. https://www. ahrq.gov/hai/cusp/index.html. 12. Eliminating catheter-associated urinary tract infections. Hospitals in Pursuit of Excellence website. http://www.hpoe.org/Reports-HPOE/eliminating_catheter_associated_urinary_tract_ infection.pdf 13. Berenholtz, SM, Lubomski, LH, Weeks, K, et al. Eliminating central-line–associated bloodstream infections: a national patient safety imperative. Infect Control Hosp Epidemiol 2014;35:56–62.

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