To address healthcare associated infections, the Agency for Healthcare Research and Quality (AHRQ) has funded and collaborated with other Federal agencies, including the Centers for Disease Control and Prevention (CDC), to develop and launch projects that prevent and reduce HAIs. These projects are primarily funded through existing AHRQ mechanisms.
In October 2008, Congress appropriated $17 million to the Agency for Healthcare Research and Quality (AHRQ) for projects to help further reduce and eliminate HAIs. The (AHRQ fact sheet here) features details of projects that AHRQ funded in fiscal year 2009 to address various infections, including central line-associated blood stream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA) infections, Clostridium difficile infections (CDIs), surgical site infections (SSIs), Carbapenem-resistant enterobacteriaceae (CRE) infections, catheter-associated urinary tract infections (CAUTIs), and blood stream infections (BSIs).
Of the total amount awarded, AHRQ is funding projects to reduce central line-associated blood stream infections and catheter-associated urinary tract infections. Building on the national implementation of the 3-year-long Comprehensive Unit-based Safety Program (CUSP) to reduce CLABSIs in intensive care units (ICUs) that began in 100 hospitals from 10 States in 2008, these programs includes tools to help health care professionals identify opportunities to reduce potential HAIs and implement policies to make care safer in the ICU.
Since the initial implementation of the CUSP-CLABSI initiative in 10 States, additional hospitals in those States have expressed interest in participating in the program. This project will increase the number of participating hospitals. Total Funding: $1,000,000
This project expands the CUSP-CLABSI initiative to 22 States, the District of Columbia, and Puerto Rico. As a result of this additional funding from AHRQ and a private foundation, all 50 States, Puerto Rico, and the District of Columbia are now participating in the Keystone Project. In an 18-month period, the Keystone Project reduced the rate of BSIs from intravenous lines by two-thirds within 3 months in more than 100 ICUs in Michigan and helped the average ICU decrease its infection rate from 4 percent to 0. Total Funding: $3,000,000
Because CLABSI is a significant problem in hospitals and in settings other than the ICU, this project expands the CUSP-CLABSI initiative to general medical and surgical hospital units. Current CUSP resources will be modified so they are applicable to a non-ICU environment. Total Funding: $2,000,000
The success of CUSP in reducing CLABSIs has increased pressure to apply the program to other HAIs, including CAUTIs; thus, this project initiates a demonstration of the CUSP concept as applied to CAUTIs. Investigators will first modify CUSP materials so they apply to CAUTI and then use the materials in 10 hospitals in each of 10 States, for a total of 100 hospitals, to demonstrate CUSP's utility in reducing CAUTIs. Total Funding: $1,000,000