AHRQ Projects to Prevent Healthcare-Associated Infections, Fiscal Year 2011

Fact Sheet

This fact sheet provides a listing of new and continuing Healthcare-Associated Infection (HAI) projects supported with Fiscal Year (FY) 2011 funding from the Agency for Healthcare Research and Quality (AHRQ).

Introduction
New Projects
Continuing Projects—Contracts
Continuing Projects—Grants
Acronyms
For More Information 

Introduction

HAIs are infections that people acquire while they are receiving treatment for another condition in a health care setting. They are costly, deadly, and largely preventable. A core part of AHRQ's mission is to improve the safety of health care for all Americans. One way AHRQ is accomplishing this mission is by funding projects to prevent and reduce HAIs.

Top of Page 

New Projects

Comprehensive Unit-based Safety Program for Ventilator-Associated Pneumonia Prevention

Funding Mechanism: Contract (ACTION II Task Order)
Contractor:Johns Hopkins University
Targeted HAIs:Ventilator-associated pneumonia (VAP)
Setting: Hospitals
Goals: This project will develop and test a Comprehensive Unit-based Safety Program (CUSP) to reduce VAP. Objectives include:
  • Identifying and selecting the CUSP-VAP intervention bundle.
  • Adapting CUSP for VAP prevention.
  • Demonstrating and field testing CUSP-VAP in two States.

Development and Demonstration of a Surgical Unit-based Safety Program to Reduce Surgical Site Infections and Other Surgical Complications

Funding Mechanism: Contract (ACTION II Task Order)
Contractor: Johns Hopkins University
Targeted HAI: Surgical site infections (SSIs) and other surgical complications
Setting: Hospitals
Goals: The goal of this project is to develop a Surgical Unit-based Safety Program (SUSP), analogous to CUSP, to reduce SSIs and other major surgical complications. Objectives include:
  • Developing SUSP as an adaptation of the CUSP protocol and developing materials to be applied to SSI and other surgical complications, including the use of teamwork assessment and the World Health Organization Safe Surgery Checklist.
  • Implementing SUSP in a phased manner beginning with 10 States and 10 hospitals in each State and then in subsequent option years expanding to all States, the District of Columbia, and Puerto Rico.

Electronic Surveillance for Wound Infections After Ambulatory Pediatric Surgery

Funding Mechanism: Grant (R01 Mechanism)
Institution: Children's Hospital of Philadelphia
Targeted HAI: SSIs
Setting: Ambulatory surgery
Goals: The goals of this project are to determine the epidemiology and improve the surveillance of SSIs after ambulatory surgery in children. To accomplish these goals, the specific aims are to:
  • Define the incidence of and risk factors for SSI after ambulatory pediatric surgery.
  • Identify the electronic health record (EHR) data elements required for the most sensitive and efficient identification of SSI after ambulatory pediatric surgery.
  • Create an EHR-based surveillance tool that will facilitate efficient and effective SSI surveillance after ambulatory pediatric surgery.

An Environmental Disinfection Intervention to Control C. difficile

Funding Mechanism: Grant (R18 Mechanism)
Institution: Case Western
Targeted HAI: Clostridium difficile infection (CDIs)
Setting: Inpatient
Goals: The long-term goal for this project is to develop improved control measures for Clostridium difficile. The central hypothesis of this project is that an evidence-based intervention to improve environmental disinfection will reduce rates of healthcare-associated CDIs. The specific aims are to:
  • Validate the effectiveness of the fluorescent marker method as a means to monitor disinfection of high-touch surfaces in rooms that have housed patients with CDIs.
  • Determine if daily disinfection of high-touch surfaces during treatment for CDIs will reduce health care workers' hand contamination.
  • Determine if an intervention to improve environmental disinfection by housekeeping staff will reduce rates of healthcare-associated CDI.

Identifying and Aligning Work System Risk Factors to Reduce Healthcare-Associated Infections

Funding Mechanism: Contract (ACTION II Task Order)
Contractor: CNA
Targeted HAI: Multiple
Setting: Multiple
Goal: The goal of this project is to focus on aligning and bundling work system, environmental, and contextual factors that can serve as a standalone intervention or that can facilitate the successful implementation of a HAI control method or tool whose effectiveness holds promise or has been previously demonstrated. Objectives include:
  • Performing an in-depth and comprehensive review of the literature that examines factors that must be aligned for successful implementation of an HAI-reduction intervention.
  • Designing and conducting an evaluation of the intervention that purposefully aligns selected work system factors to reduce HAIs.
  • Preparing and disseminating a toolkit that enables other organizations to implement the HAI reduction strategy.

Impact of Methicillin-resistant Staphylococcus aureus Decolonization Therapy on MRSA Infection and Transmission

Funding Mechanism: Grant (R01 Mechanism)
Institution: Medical University of South Carolina
Targeted HAI: Methicillin-resistant Staphylococcus aureus (MRSA)
Setting: Inpatient
Goals:This project will compare the effectiveness of a standard patient isolation strategy with placebo decolonization with a strategy of isolation and active decolonization for hospital inpatients colonized with MRSA with respect to the following endpoints:
  • Reducing infection rates pre-discharge from the hospital among the index patients.
  • Reducing subsequent infections post-discharge among those without an infection in the index hospitalization.
  • Reducing transmission of MRSA to household members post-discharge.

Modifying Contact Precautions for Methicillin-resistant Staphylococcus aureus in Extended Care

Funding Mechanism: Grant (R18 Mechanism)
Institution: University of Maryland
Targeted HAI: MRSA
Setting: Long-term care (LTC) facilities
Goals: The goal of this project is to determine the optimal use of contact precautions for community-based LTC facilities. The specific aims of this project are to:
  • Estimate the frequency of MRSA transmission and risk factors for MRSA transmission to protective gowns worn by health care workers interacting with MRSA-colonized LTC residents.
  • Use activity-based costing to estimate the costs of gown use in LTC facilities for the different options from Centers for Disease Control and Prevention guidelines in different types of LTC facilities.

National Implementation of Comprehensive Unit-based Safety Program to Reduce Catheter-Associated Urinary Tract Infections

Funding Mechanism: Contract (ACTION II Task Order)
Contractor: Health Research & Educational Trust
Targeted HAI: Catheter-associated urinary tract infection (CAUTI)
Setting: Hospitals
Goals: This project expands the previously funded CUSP to reduce CAUTIs from a 12-State pilot effort to allow participation by more States. Objectives include:
  • Expanding the CUSP-CAUTI initiative to 15 more States and providing funding for coordination and data analysis. Option years 1, 2, and 3 would expand the initiative to all 50 States, the District of Columbia, and Puerto Rico.
  • Expanding or enhancing existing statewide consortium efforts to reduce HAIs including CAUTIs.

Risk Factors for Community-Onset Healthcare-Acquired Urinary Tract Infections

Funding Mechanism:Grant (R03 Mechanism)
Institution:Oregon State University
Targeted HAI:Healthcare-associated urinary tract infections (UTIs)
Setting: Multiple
Goals: The long-term goal of this project is to utilize epidemiologic data to develop interventions aimed at reducing the incidence of healthcare-associated UTIs. The objective of this research is to collect preliminary data that can guide future epidemiologic studies of community-onset, healthcare-associated UTIs. To accomplish this objective, the aims of the project are to:
  • Estimate the incidence of community-onset, hospital-acquired UTIs diagnosed among patients hospitalized on the family medicine service at Oregon Health & Science University.
  • Identify potential risk factors for the development of community-onset, hospital-acquired UTIs.

Synthesis of Results of AHRQ-Funded Healthcare-Associated Infection Projects: Fiscal Year 2007 Through Fiscal Year 2010

Funding Mechanism: Contract (PEATOC Task Order)
Contractor: IMPAQ/RAND
Targeted HAI: Multiple
Setting: Multiple
Goals: The goal of this project is to develop and disseminate a synthesis of results of AHRQ's HAI projects that were funded in FY 2007 through FY 2010. Objectives include:
  • Identifying and promoting application of effective HAI prevention approaches.
  • Identifying gaps in the HAI science base.
  • Identifying opportunities to further fund projects of knowledge generation and implementation to prevent HAIs.

Understanding the Role of Health Care Facility Design in the Acquisition and Prevention of Healthcare-Associated Infections

Funding Mechanism: Contract (ACTION II Task Order)
Contractor: RTI International
Targeted HAI: Multiple
Setting: Multiple
Goals: The overall goal of this project is to better understand and describe the role of health care facility design in the acquisition and prevention of HAIs. Objectives include:
  • Developing a conceptual framework that describes the relationship between the built environment of health care facilities and the acquisition and prevention of HAIs and that can be used to guide and assess future research.
  • Conducting an environmental scan to understand the current state of knowledge of HAI prevention through the use of the built environment.

Top of Page 

Continuing Projects—Contracts

Cluster Randomized Trial of Hospitals to Assess the Impact of Targeted vs. Universal Strategies to Reduce MRSA in Intensive Care Units.

Do High-Performance Work Practices Facilitate Healthcare-Associated Infection Interventions?

Healthcare Cost and Utilization Project: National and Regional Projections of HAIs in the Acute Care Setting.

Longitudinal Evaluation of the U.S. Department of Health and Human Services Action Plan to Reduce Healthcare-Associated Infections.

National Implementation of Comprehensive Unit-based Safety Program to Reduce Central Line-Associated Blood Stream Infections.

National Opportunity to Improve Infection Control in ESRD (NOTICE) Initiative (Previous name: Improving Infection Control in Practices in End-Stage Renal Disease Facilities).

Optimizing Pre-Operative Surgical Antibiotic Prophylaxis for the 21st Century.

Reducing Infections Caused by Carbapenem-Resistant Enterobacteriaceae (KPC-Producing Organisms) through Application of Recently Developed Recommendations.

Standardization of Antibiotic Use in Long-Term Care (SAUL).

Supporting AHRQ Projects on Reducing HAIs with Market Research and Dissemination.

Top of Page 

Continuing Projects—Grants

Central Venous Catheter-Related Blood Stream Infections in Pediatric Cancer.

Detection, Education, Research, and Decolonization Without Isolation in Long-Term Care.

Emergency Department Best Practices to Reduce Healthcare-Associated Infections.

Epidemiology of Rural MRSA: Is Livestock Contact a Risk Factor?

Evaluating Clostridium difficile Infection in Hospitalized Patients.

Multidrug-Resistant Urinary Tract Infections in Ambulatory Settings.

PHIS+: Augmenting the Pediatric Health Information System with Clinical Data.

Preventing/Managing Clostridium difficile for Nursing Home Residents, Admissions and Discharges.

Project CLEAR—Changing Lives by Eradicating Antibiotic Resistance.

Quality of Care and Outcomes of Health Care-Associated Pneumonia.

Reducing Healthcare-Associated Infections Using an Infection Control Network.

Surgical Site and Clostridium difficile Infections after Ambulatory Surgery.

Targeting Hospital-Acquired Complications: Impact on the Care of Complex Patients.

Translating Comparative Effectiveness Research Results from Intensive Care Unit Study to Improve Outcomes in Cardiac Surgery.

Top of Page 

Acronyms

ACTION—Accelerating Change and Transformation in Organizations and Networks
CAUTI—Catheter-associated urinary tract infection
CDIs—Clostridium difficile infections
CUSP—Comprehensive Unit-based Safety Program
EHR—Electronic health record
ESRD—End-stage renal disease
HAIs—Healthcare-associated infections
KPC—Klebsiella pneumonia carbapenemase
LTC—Long-term care
MRSA—Methicillin-resistant Staphylococcus aureus
NOTICE—National Opportunity to Improve Infection Control in ESRD
PEATOC—Program Evaluation and Analysis Task Order Contract
PHIS—Pediatric Health Information System
SAUL—Standardization of Antibiotic Use in Long-Term Care
SSIs—Surgical site infections
SUSP—Surgical Unit-based Safety Program
UTIs—Urinary tract infections
VAP—Ventilator-associated pneumonia

Top of Page 

For More Information

AHRQ's HAI projects funded in FY 2010, FY 2009, and FY 2008 and earlier can be found at the following links:

Background information on HAIs and AHRQ's work to reduce them is available at the AHRQ Fact Sheet, Research Initiatives on Health Care-Associated Infections.

For more information about AHRQ's HAI initiatives, visit http://www.ahrq.gov/qual/hais.htm or contact:

James I. Cleeman, M.D.
Senior Medical Officer
Center for Quality Improvement and Patient Safety
Agency for Healthcare Research and Quality
540 Gaither Road, Room 3238
Rockville, MD 20850
Phone: 301/427-1330
E-mail: james.cleeman@ahrq.hhs.gov

Current as of October 2010
Internet Citation: AHRQ Projects to Prevent Healthcare-Associated Infections, Fiscal Year 2011: Fact Sheet. October 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/errors-safety/haify11/index.html