Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA.
Crit Care Med. 2010 Aug;38(8 Suppl):S292-8. doi: 10.1097/CCM.0b013e3181e6a165.
Healthcare-associated infections are common, costly, and often lethal. Although there is growing pressure to reduce these infections, one project thus far has unprecedented collaboration among many groups at every level of health care. After this project produced a 66% reduction in central catheter-associated bloodstream infections and a median central catheter-associated bloodstream infection rate of zero across >100 intensive care units in Michigan, the Agency for Healthcare Research and Quality awarded a grant to spread this project to ten additional states. A program, called On the CUSP: Stop BSI, was formulated from the Michigan project, and additional funding from the Agency for Healthcare Research and Quality and private philanthropy has positioned the program for implementation state by state across the United States. Furthermore, the program is being implemented throughout Spain and England and is undergoing pilot testing in several hospitals in Peru. The model in this program balances the tension between being scientifically rigorous and feasible. The three main components of the model include translating evidence into practice at the bedside to prevent central catheter-associated bloodstream infections, improving culture and teamwork, and having a data collection system to monitor central catheter-associated bloodstream infections and other variables. If successful, this program will be the first national quality improvement program in the United States with quantifiable and measurable goals.
医疗机构相关感染十分常见，不仅耗费巨大，而且往往致命。尽管现在有越来越大的压力要求减少这些感染，但迄今为止，只有这个项目在各级医疗机构的许多团体之间进行了前所未有的合作。在该项目实施后，密歇根州的 100 多个重症监护病房中，中心静脉导管相关血流感染减少了 66%，中心静脉导管相关血流感染的中位数为零。美国医疗保健研究与质量局为此项目提供了一项拨款，以将其推广到另外十个州。该项目被称为 On the CUSP: Stop BSI，由密歇根州项目衍生而来，美国医疗保健研究与质量局和私人慈善机构的额外资金为该项目在美国各州的实施做好了准备。此外，该项目正在西班牙和英国实施，并正在秘鲁的几家医院进行试点测试。该项目中的模式平衡了在科学严谨性和可行性之间的紧张关系。该模式的三个主要组成部分包括将证据转化为床边实践，以预防中心静脉导管相关血流感染，改善培养和团队合作，以及建立一个数据收集系统，以监测中心静脉导管相关血流感染和其他变量。如果成功，该项目将成为美国首个具有可量化目标的全国性质量改进项目。
