At its 2010 annual meeting, the Association for Professionals in Infection Control and Epidemiology (APIC) launched its new "I Believe in Zero CLABSIs" campaigna collaborative effort based on the national project titled, "OntheCUSP: StopBSI," being coordinated by the American Hospital Associations Health Research and Educational Trust (HRET). The underlying framework for OntheCUSP came from a multicenter collaborative that resulted in remarkable reductions in the incidence of CLABSI rates among critically ill patients first reported in the Michigan Keystone ICU Project an overall 66 percent reduction, and at many participating facilities, elimination was realized for prolonged periods of time.(1-2) Importantly, the scientific foundation for the CLABSI prevention "bundle" came from evidenced-based recommendations issued by the Centers for Disease Control & Prevention (CDC)s Healthcare Infection Control Practices Advisory Committee (HICPAC). Others also have demonstrated efficacy of a composite of prevention interventions.(3-6)
OntheCUSP: StopBSI is currently active in nearly 30 states. The District of Columbia, Puerto Rico, and the remaining states are targeted for involvement by early next year. Yet the percent of hospitals enrolled in this voluntary program varies widely across the United States. In fact, a recent survey finds only 26 percent of states have a collaborative in place or one that is being planned.(7) As many infection preventionists are aware already, the Centers for Medicare and Medicaid Services (CMS) announced in June that hospitals need to report CLABSIs in adult and neonatal ICUs through the CDC National Healthcare Safety Network database starting in January 2011, if they want the opportunity to receive full Medicare payments 2013. CMS also announced that ICU CLABSI will be publically reported on the Hospital Compare website. With these recent developments, the pressure to eliminate preventable CLABSI has never been greater.
APIC says it needs its members' help to achieve the goal of zero preventable CLABSI. The organization encourages IPs to join this campaign and participate in monthly calls with the nearly 1,000 hospitals across the country that will provide valuable information surrounding their experiences in reducing CLABSI as well as focusing on overcoming barriers. In addition, surveillance of CLABSI indicates there are ample opportunities for elimination, e.g., "after the insertion bundle" and also in units outside the ICU setting.
On Nov. 16, 2010, from 2 p.m. to 3 p.m. EST, APIC president-elect Russ Olmsted, MPH, CIC will be the guest speaker, and will focus on the role of APIC and infection preventionists in this work. APIC members are asked to dial in to share your ideas and experience on how to leverage our commitment to a shared goal of zero preventable CLABSI. If your healthcare facility is not yet enrolled in the project, members of the national team will be on hand to describe how to get involved.
The number to call is (866) 238-0637 and the Operator Code is "CUSP Supplemental Call."
1. Pronovost P, et a. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006 Dec 28;355(26):2725-32.
2. Pronovost PJ, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. BMJ. 2010 Feb 4;340:c309
3. CDC. Reduction in Central Line--Associated Bloodstream Infections Among Patients in Intensive Care Units --- Pennsylvania, April 2001--March 2005. MMWR 2005;54:1013-16.
4. Guerin K , et a. Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle. Am J Infect Control. 2010 Aug;38(6):430-3
5. Jeffries HE, et al. Prevention of central venous catheter-associated bloodstream infections in pediatric intensive care units: a performance improvement collaborative. Infect Control Hosp Epidemiol. 2009 Jul;30(7):645-51.
6. Koll BS, et al. The CLABs collaborative: a regionwide effort to improve the quality of care in hospitals. Jt Comm J Qual Patient Saf. 2008 Dec;34(12):713-23
7. Murphy DJ,et al. Monitoring and reducing central line-associated bloodstream infections: a national survey of state hospital associations. Am J Med Qual. 2010 Jul-Aug;25(4):255-60