Influence of the Comprehensive Unit–based Safety Program in ICUs: Evidence From the Keystone ICU Project

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Abstract

Using data from the Keystone ICU project, this study examined whether the intensive care units (ICUs) that implemented the Comprehensive Unit-based Safety Program (CUSP) would have greater improvement in safety climate, team progress barriers, and central line–associated bloodstream infections (CLABSIs) than ICUs not implementing CUSP. The study population consisted of 103 ICUs; 60 ICUs (58%) used CUSP, with 6 of them later discontinuing CUSP, and 17 ICUs (16.5%) never used CUSP. The researchers could not determine CUSP use status for the remaining 26 ICUs because of missing data. The use of CUSP was associated with improved safety climate, job satisfaction, and working conditions after a 2-year period, as measured by the Safety Attitudes Questionnaire. Study results on barriers and CLABSIs are inconclusive. This study demonstrated that unit-based, formalized processes targeting cultural improvements in teamwork, communication, self-identification of hazards, and hazard mitigation can improve several aspects of patient safety climate in ICUs.

Original languageEnglish (US)
Pages (from-to)349-357
Number of pages9
JournalAmerican Journal of Medical Quality
Volume31
Issue number4
DOIs
StatePublished - Jul 1 2016

Keywords

  • catheter-related infections
  • intensive care unit
  • safety climate
  • safety culture

ASJC Scopus subject areas

  • Health Policy

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