Safety program helps NICUs slash CLABSI rate

Central-line associated bloodstream infections in newborns were reduced by 58% within a year in NICUs participating in an Agency for Healthcare Research and Quality patient safety program.

Frontline caregivers in 100 NICUs in nine states relied on the program’s prevention practice checklists and better communication to prevent an estimated 131 infections and up to 41 deaths and avoid more than $2 million in healthcare costs.

Healthcare teams in the project states, caring for a total of 8,400 newborns, used the AHRQ’s Comprehensive Unit-based Safety Program to improve safety culture and consistently implement catheter insertion and maintenance guidelines. CUSP is designed to be customizable and help hospitals understand and apply the science of safety and take actions to improve teamwork and communications. The 11-month project involved using CUSP to help clinical teams focus on safe practices and appropriate steps when using central lines based on guidelines from the Centers for Disease Control and Prevention.

Each state-based team was led by a neonatologist who worked with the state’s hospital association to implement the project. When the project began, participating NICUs had an overall infection rate of 2.043 per 1,000 central line days. At the end of the project, that rate was reduced to 0.855 per 1,000 central line days, a relative reduction of 58%.

“The CUSP framework brings together safety culture, teamwork and best practices — a combination that is clearly working to keep these vulnerable babies safer,” AHRQ Director Carolyn M. Clancy, MD, said in a news release. “These remarkable results show us that, with the right tools and dedicated clinicians, hospital units can rapidly make care safer.”

For more information on how NICUs achieved this reduction, visit

The nine-state project in NICUs is part of a larger AHRQ-funded effort to implement CUSP to prevent CLABSIs nationwide. Final results of the national implementation project are available and show that CLABSIs were reduced by 41% in adult ICUs. The final report is available at

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