AHRQ casts wide net of HAI research projects
Hospital projects include SSIs
The federal Agency for Healthcare Research and Quality's (AHRQ) $34 million initiative to prevent health care associated infections (HAIs) includes the following hospital-based projects. Look to future issues of Hospital Infection Control & Prevention for full findings and analysis of these projects.
Effect of the use of universal glove and gowning on HAI rates: This project will determine the effectiveness of universal glove and gowning procedures in reducing HAI rates in intensive care units (ICUs). Objectives include:
- Documenting the effectiveness, costs, and unintended consequences associated with implementing universal glove and gowning procedures.
- Disseminating the study findings, including information about the costs and unintended consequences.
Evaluating Clostridium difficile infection in hospitalized patients: This project will evaluate the extent to which hospital-level antibiotic and gastric acid suppressant usage patterns, infection prevention and control, and pharmacy policies predict CDI occurrence; develop and compare various approaches to risk adjustment to identify hospitals with higher- or lower-than-expected CDI rates; and identify facilitators and barriers to implementation of best practices for CDI prevention.
National implementation of comprehensive unit-based safety program (CUSP) to reduce central line-associated blood stream infections (CLABSIs): This project expands the previously funded project to reduce CLABSI to allow participation by all units and in all hospitals that wish to reduce CLABSI rates. Objectives include:
- Expanding the CUSP-CLABSI efforts to include all interested hospitals in the 10 States that were funded in fiscal year 2008.
- Expanding the current CUSP-CLABSI efforts in the intensive care unit (ICU) to include all states, Puerto Rico, and the District of Columbia and increase the number of hospitals per state that participate in the effort.
- Extending the current CUSP-CLABSI efforts to demonstrate the effectiveness of CUSP in reducing CLABSI in hospital units outside the ICU.
Central venous catheter-related blood stream infections in pediatric cancer: This project will perform a study comparing the impact of using a specialty team of nurses providing evidence-based central venous catheter care versus the use of assigned bedside nurses on reducing central venous catheter-related blood stream infections among pediatric oncology patients.
Translating comparative effectiveness research results from ICU study to improve outcomes in cardiac surgery: This project will implement and evaluate the impact of CUSP on rates of SSIs and cardiac operating room safety culture; on rates of CLABSI, ventilator-associated pneumonia, and safety culture in cardiac surgical ICUs; on errors associated with handoffs from the ICU to the floor and discharge from the hospital; and on 30-day mortality, hospital readmissions, and hospital length of stay in cardiac operating rooms, ICUs, and floors compared to passive feedback of outcome data.
Quality of care and outcomes of health care-associated pneumonia: This project will characterize the clinical features and outcomes of patients hospitalized with health care-associated pneumonia compared to patients hospitalized with community-acquired pneumonia. It will refine and validate an inpatient pneumonia mortality model using hospital claims data and assess adherence to antibiotic prescribing guidelines in the setting of health care-associated pneumonia and identify factors associated with guideline-concordant treatment.
Optimizing pre-operative surgical antibiotic prophylaxis: This project aims to determine whether a pre-operative antibiotic prophylaxis algorithm that includes the use (including selective use) of antibiotics shown to be effective against resistant gram-positive organisms is effective in reducing the number of SSIs attributable to resistant gram-positive organisms. Objectives include:
- Conducting an environmental scan of existing pre-operative antibiotic prophylaxis algorithms for the prevention of cardiac and orthopedic SSIs.
- Developing one or more new prophylaxis algorithms that incorporate the use of antibiotics with demonstrated effectiveness against resistant gram-positive organisms.
- Designing and conducting a study to compare the new algorithm(s) against standard algorithms used for administering pre-operative antibiotic prophylaxis of SSIs in cardiac and orthopedic surgery.
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