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www.ahrq.gov/patient-safety/about/challenge-competition.html
February 01, 2024 - Implementation focused on MU Health Care’s 390-bed University Hospital, the only level I trauma center in central … Read the impact story: University of Chicago Medicine
UChicago Medicine reduced venous thromboembolism … patient population across their institution with the use of AHRQ’s Preventing Hospital-Associated Venous
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/implementation-guide.pdf
April 01, 2022 - resources that enhance previous Comprehensive Unit-
based Safety Program (CUSP) resources to reduce central … • CLABSI Modules
o Central Venous Catheter Indications and Alternatives – avoiding placement and … determining appropriateness
o Central Venous Catheter Insertion Bundle – avoiding improper placement … techniques
o Central Venous Catheter Maintenance – maintaining awareness and proper care
of catheters … in place
o Central Venous Catheter Removal – prompting removal of unnecessary
catheters
• CAUTI
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4i_combo_psi12-dvt-bestpractices.pdf
May 20, 2016 - Recommended Practice Details of Recommended Practice
Venous Thromboembolism (VTE) Risk
Assessment … Varicose veins with associated phlebitis
Fracture of pelvis/hip/lower extremity
Indwelling central … Preventing hospital-associated venous thromboembolism: a guide for effective
quality improvement, 2nd … Venous thromboembolism:
reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary … Venous thromboembolism diagnosis and treatment.
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www.ahrq.gov/hai/pfp/interimhac2013-ref.html
December 01, 2014 - http://www.ncbi.nlm.nih.gov/pubmed/19194330
Central Line-Associated Bloodstream Infections
CDC Vital … Signs—Central line associated blood stream infections—U.S. 2001, 2008, 2009. … Strategies to prevent central line–associated bloodstream infections in acute care hospitals. … Reduction in central line-associated bloodstream infections among patients in intensive care units—Pennsylvania … Preventing hospital-acquired venous thromboembolism: a guide for effective quality improvement.
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www.ahrq.gov/hai/pfp/hacrate2013-refs.html
October 01, 2015 - Central Line-Associated Bloodstream Infections
CDC Vital Signs—Central line associated blood stream … Strategies to prevent central line–associated bloodstream infections in acute care hospitals. … Reduction in central line-associated bloodstream infections among patients in intensive care units—Pennsylvania … Venous Thromboembolisms (post-surgery)
AHRQ Health Care Innovations Exchange. … Preventing hospital-acquired venous thromboembolism: a guide for effective quality improvement.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/qi-action-slides.pptx
April 01, 2022 - How might we . . . address central line maintenance issues? … Remove central lines as soon as no longer needed. … Unit Data – Central line SUR = 1.17
ICU Assessment – No consistent daily review for necessity
Hospital … Venous Catheter Removal module
AHRQ Safety Program for ICUs: Preventing CLABSI and CAUTI
QI in Action … Central Venous Catheter-Associated Laboratory-Confirmed Blood Stream Infection Event Report Template
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/data-change-notes.docx
April 01, 2022 - with the application of the central line dressing, then this information should be surfaced rapidly … It also provides your unit’s device utilization ratio, or the number of catheter or central line days … Using an in-depth data review, the ICU found its utilization of central venous catheters had also increased … venous catheter placement and hemodynamic monitoring during specific cases. … For example, a central venous catheter dressing change kit is not well received by clinicians because
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www.ahrq.gov/patient-safety/settings/hospital/vtguide/guide5.html
October 01, 2022 - Preventing Hospital-Associated Venous Thromboembolism
Chapter 5. … Protocol
Previous Page Next Page
Table of Contents
Preventing Hospital-Associated Venous … A daily reminder to reassess and certify the need for a central venous catheter is an example that can … A central challenge of standardization is constructing protocols that work for the great majority of … They illustrate the central importance of implementation and clinical decision support techniques across
-
www.ahrq.gov/es/patient-safety/settings/hospital/vtguide/guide5.html
October 01, 2022 - Preventing Hospital-Associated Venous Thromboembolism
Chapter 5. … Protocol
Previous Page Next Page
Table of Contents
Preventing Hospital-Associated Venous … A daily reminder to reassess and certify the need for a central venous catheter is an example that can … A central challenge of standardization is constructing protocols that work for the great majority of … They illustrate the central importance of implementation and clinical decision support techniques across
-
www.ahrq.gov/patient-safety/resources/learning-lab/enhancing-long-desc.html
April 01, 2021 - The display improved provider's awareness of indwelling urinary catheters, central venous catheters, … The improvement in provider awareness of central venous catheters was significant for intervention rooms
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cusp-icu-slides.pptx
April 01, 2022 - Short-term central venous catheter dressing changed daily, despite site being clean, dry, and intact … Daily central line maintenance bundle checklist to assess dressing and documentation of date changed … Reduction of central venous catheter associated blood stream infections following implementation of a … Preventing Central Line-Associated Bloodstream Infections: Useful Tools, An International Perspective … Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/impl-guide/implementation-guide-appendix-l.pdf
September 01, 2015 - immobility (Foley is considered a "one-point
restraint"), hospital-acquired pressure ulcers, falls, and venous … Enhancing the Safety of Critically Ill Patients by Reducing Urinary and Central
Venous Catheter-related
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf
June 02, 2025 - Surgical Item or Unretrieved Device Fragment Count
• PSI 06 Iatrogenic Pneumothorax Rate
• PSI 07 Central … Venous Catheter-Related Blood Stream Infection Rate
• PSI 08 Postoperative Hip Fracture Rate
• PSI … Failure Rate
• PDI 10 Postoperative Sepsis Rate
• PDI 11 Postoperative Wound Dehiscence Rate
• PDI 12 Central … Venous Catheter-Related Blood Stream Infection Rate
In addition, a more general best practices form
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Shah_99.pdf
March 23, 2008 - line, and sustaining a complication”; (b) “Giving patient
pneumothorax post-central venous access placement … Context: Placing central venous access in patient
Standard of care: Checking coagulants
Injury: Hematoma … Context: Post Central venous access placement
in patient
Standard of care: Checking a chest x ray … Context: Placing central venous access in patient
Standard of care: Checking coagulants
Injury: Hematoma … Context: Post Central venous access placement in
patient
Standard of care: Checking a chest x ray
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2022-adverse-event-data-report-nov-rev.pdf
January 01, 2022 - venous catheter
7 2944 0.2 0.1 – 0.5
Non-OR related burn or electric shock
events
1 22678 0.0 … venous
catheter
1 644 0.2 0.0 –
0.9
6 2300 0.3 0.1 –
0.6
Non-OR related burn
or electric … At Risk
AE
Rate
(%) 95% CI
Venous
Thromboembolism
(VTE)
29 11746 0.3 0.2 – 0.4 36 9903 0.4 … venous
catheter
0 619 0.0 0.0 –
0.6
7 2249 0.3 0.2 –
0.6
Non-OR related
burn or electric … venous
catheter
4 1460 0.3 0.1 –
0.7
3 1408 0.2 0.1 – 0.6
Non-OR related
burn or electric
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2022-adverse-event-data-report-oct-rev.pdf
January 01, 2022 - venous catheter
7 2944 0.2 0.1 – 0.5
Non-OR related burn or electric shock
events
1 22678 0.0 … venous
catheter
1 644 0.2 0.0 –
0.9
6 2300 0.3 0.1 –
0.6
Non-OR related burn
or electric … At Risk
AE
Rate
(%) 95% CI
Venous
Thromboembolism
(VTE)
29 11746 0.3 0.2 – 0.4 36 9903 0.4 … venous
catheter
0 619 0.0 0.0 –
0.6
7 2249 0.3 0.2 –
0.6
Non-OR related
burn or electric … venous
catheter
4 1460 0.3 0.1 –
0.7
3 1408 0.2 0.1 – 0.6
Non-OR related
burn or electric
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www.ahrq.gov/patient-safety/settings/hospital/vtguide/appc.html
May 01, 2016 - Preventing Hospital-Associated Venous Thromboembolism
Appendix C: VTE Measurement and Tracking … Previous Page
Table of Contents
Preventing Hospital-Associated Venous Thromboembolism … track these separately, as efforts to improve upper extremity DVT might focus on reducing inappropriate central … venous catheter use as much as on increasing pharmacologic prophylaxis. … 453.85
Acute venous embolism and thrombosis of subclavian veins
453.86
Acute venous
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www.ahrq.gov/es/patient-safety/settings/hospital/vtguide/appc.html
May 01, 2016 - Preventing Hospital-Associated Venous Thromboembolism
Appendix C: VTE Measurement and Tracking … Previous Page
Table of Contents
Preventing Hospital-Associated Venous Thromboembolism … track these separately, as efforts to improve upper extremity DVT might focus on reducing inappropriate central … venous catheter use as much as on increasing pharmacologic prophylaxis. … 453.85
Acute venous embolism and thrombosis of subclavian veins
453.86
Acute venous
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/b4_pdi_documentationcoding.pdf
March 15, 2016 - Venous Catheter-Related Bloodstream
Infection [CLABSI]). … Validity of the AHRQ Patient Safety Indicator
“central venous catheter-related bloodstream infections … PDI 12 Central Venous Catheter-
Related Blood Stream
Infection
Differentiate between a central line … CV-CRBSI is “infection due to central venous catheter,” which means that the catheter is the source … PDI 12 Central Venous
Catheter-Related
Bloodstream
Infections (CV-
CRBI)
X Bloodstream infections
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/clabsi-learning-from-defects_revised.docx
April 01, 2022 - CLABSI Learning From Defects Tool
Learn From Defects Tool Worksheet:
Central Line-Associated Bloodstream … Tunneled (other than dialysis)
· Dialysis (tunneled)
· Dialysis (nontunneled)
· Peripherally inserted central … (Select all that apply)
· Hemodynamic monitoring
· Poor venous access
· Long-term antibiotics … Yes No Uncertain
10) Was the blood culture drawn from this central line?