AHRQ's Healthcare-Associated Infections Program

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.
• 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. Learn more about the HHS role in developing the Action Plan.

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 1,000 ICUs that reduced central line-associated blood stream infections by 41 percent. Visit the CUSP Method for more information.

• 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 MRSA Prevention in ICU & Non-ICU Settings
   
  This toolkit equips healthcare professionals with the essential knowledge, resources, and tools to tackle prevention of methicillin-resistant Staphylococcus aureus (MRSA) in hospital intensive care units and non-intensive care units.  
   
• Toolkit for Improving Surgical Care and Recovery 
  
  This toolkit helps hospitals implement evidence-based practices to improve outcomes and prevent complications among patients who undergo surgery. 
   

• Toolkits To Improve Antibiotic Use

  Three toolkits that help hospitals, long-term care facilities, and ambulatory practices apply the Four Moments of Antibiotic Decision Making to improve antibiotic use.

• Toolkit for Preventing CLABSI and CAUTI in ICUs

  This toolkit provides the clinical and cultural guidance to help hospital intensive care units (ICUs) make changes needed to decrease rates of central line-associated blood stream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Using CUSP and other evidence-based practices, the toolkit helps ICUs assess their current CLABSI and CAUTI prevention efforts, has resources to help ICUs overcome common challenges in infection-reduction efforts, and provides the clinical and cultural guidance to make changes needed to decrease CLABSI and CAUTI rates.

• 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.

• Toolkit To Promote Safe Surgery

  This toolkit helps 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 MRSA Prevention

  This ongoing implementation project aims to help intensive care units, non-intensive care units, surgical services, and long-term care facilities measurably decrease invasive methicillin-resistant Staphylococcus aureus infections using the CUSP method.

Other Tools 

• Toolkit for Decolonization of Non-ICU Patients With Devices

  This toolkit can help hospital infection prevention programs implement a decolonization protocol that was found to reduce bloodstream infections by roughly 30 percent in adult inpatients who were not in intensive care units and who had specific medical devices. It includes implementation instructions, demonstration videos, and customizable tools.

• Community-Acquired Pneumonia Clinical Decision Support Implementation Toolkit

  This toolkit is a resource to help clinicians and clinical informaticians in primary care and other ambulatory settings implement and adopt the community-acquired pneumonia (CAP) clinical decision support (CDS) alert for the management of community-acquired pneumonia.

• 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).

• 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

• 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.

• 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.

HAI and CARB Funding

Learn more about HAI and CARB funding.

Are you presenting an abstract about your HAI or CARB research at an upcoming HAI conference? If so, send the title of your abstract and information about the conference to patientsafety@ahrq.hhs.gov so we can help promote your work.