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PSNet: Patient Safety Network
Journal Article

An intervention to decrease catheter-related bloodstream infections in the ICU.

Pronovost P, Needham D, Berenholtz S, et al. The New England journal of medicine. 2006;355:2725-32.

Catheter-related bloodstream infections (CRBSI) remain a common and deadly patient safety issue in intensive care units (ICUs), although prior research has defined several effective preventive strategies. In the “Keystone ICU” project, funded by the Agency for Healthcare Research and Quality (AHRQ), 103 ICUs in Michigan participated in a statewide safety initiative, including instituting five evidence-based preventive strategies recommended by the Centers for Disease Control and Prevention (CDC). The project focused on changing provider behavior through addressing safety culture, incorporating a centralized education program for team leaders at each institution, and closely collaborating with infection control personnel. The intervention was remarkably successful, nearly eliminating CRBSI entirely in most ICUs over an 18-month follow-up period. A related editorial lauds the success of the intervention and calls for all U.S. hospitals to adopt similar programs.