AHRQ Views: Blog posts from AHRQ leaders
Help for Nursing Homes in Fighting HAIs
Patient Safety Awareness Week is an excellent time to discuss the safety of nursing home residents. Here's why: many nursing home residents face a multitude of health challenges, and fighting a preventable infection shouldn’t be one of them.
Unfortunately, healthcare-associated infections, or HAIs, occur frequently among nursing home residents. How frequently? Up to an estimated 3.8 million infections per year, leading to an estimated 388,000 deaths annually. Among these, a common HAI is catheter-associated urinary tract infection (CAUTI)—a type of infection that is largely avoidable.
CAUTIs are considered avoidable because we generally know how to prevent them. Evidence shows that practices such as removing catheters when they are no longer needed, finding ways to keep from using them unnecessarily in the first place, and aseptic insertion and maintenance of catheters all contribute to avoiding CAUTIs. In addition, understanding how to use urine cultures appropriately can help avoid overuse of antibiotics.
Although there is guidance about what to do, it hasn't been widely known how to make that knowledge a part of everyday practice at the bedside. But now a newly released AHRQ toolkit should fill that gap and make things easier for nursing homes.
The toolkit is based on an AHRQ-funded implementation project in which our national project team, led by the Health Research & Educational Trust worked hand in hand with nursing home staffs across the country to figure out how they can prevent CAUTIs and other HAIs. The project focused on adapting what we already know works—AHRQ’s Comprehensive Unit-based Safety Program, or CUSP—for the nursing home setting. CUSP has been used successfully to reduce CAUTIs and central line-associated bloodstream infections (CLABSIs) in hospitals.
To help other nursing homes benefit from the experiences of those that participated in the project, we’ve packaged the tools, resources, and knowledge from the endeavor into the Toolkit to Reduce CAUTI and Other HAIs in Long-Term Care Facilities. It offers practical, easy-to-use guidance to nursing homes on preventing CAUTI among their residents. The resources in this toolkit take providers beyond prevention protocols and surveillance to implementation and adoption. It’s not just where to go. It’s how to get there.
CUSP combines clinical best practices for infection prevention with improvement in safety culture and an increased focus on teamwork and communication. The results are safer care through fewer infections, less money spent on preventable HAIs, and lives saved.
One final point: most of the new toolkit is targeted to nursing home providers. But there is a module for engaging nursing home residents and family members as well. This portion of the toolkit educates about how to be a safe resident, such as the importance of using antibiotics properly. Using antibiotics only when necessary can reduce the risk of antibiotic resistance. Each infection prevented is one less episode of antibiotic use. Making sure that antibiotics retain the power to save lives is something in which everyone, including residents, has a stake.
This week, as we focus on patient safety, let’s renew our promise to protect both patients and nursing home residents from HAIs. AHRQ’s Healthcare-Associated Infections Program illustrates the Agency’s longstanding commitment to preventing HAIs. Our track record of success and our history of working hand in hand with clinicians on the front lines of care to make change in the delivery of health care demonstrate that we are committed to meeting this challenge. We look forward to working with you in our ongoing effort to make health care safer for everyone across the United States.