Implementation of the Comprehensive Unit-Based Safety Program to Improve Infection Prevention and Control Practices...

Area of Science:

• Healthcare Improvement Science
• Infection Prevention and Control
• Neonatal Intensive Care

Background:

• Neonatal intensive care units (NICUs) face challenges in infection prevention and control (IPC).
• Implementing standardized safety programs is crucial for improving patient outcomes in high-risk environments.
• The Comprehensive Unit-based Safety Program (CUSP) is a recognized methodology for enhancing healthcare safety.

Purpose of the Study:

• To implement and evaluate the Comprehensive Unit-based Safety Program (CUSP) in four NICUs in Pune, India.
• To improve key infection prevention and control (IPC) practices, including hand hygiene, aseptic techniques, and medication administration.
• To assess the impact of CUSP on healthcare-associated infections, patient safety culture, and workload.

Main Methods:

• Quasi-experimental study involving the implementation of CUSP in four Indian NICUs.
• Focus areas included hand hygiene, aseptic technique for invasive procedures, and medication/fluid preparation and administration.
• Data collected on CUSP fidelity, hand hygiene compliance, central line insertion checklist completion, HA-BSI rates, mortality, safety culture, and workload.

Main Results:

• CUSP training completed by 144 healthcare workers; all sites maintained regular meetings.
• Significant increase in hand hygiene compliance (6% monthly increase) and central line insertion checklist completion (83% fully completed).
• No significant change in all-cause mortality or healthcare-associated bloodstream infection (HA-BSI) rates; notable improvements in safety culture domains and increased workload.

Conclusions:

• CUSP implementation successfully enhanced hand hygiene compliance, central line care, and patient safety culture in Indian NICUs.
• The program demonstrates potential as a framework for low- and middle-income countries to mitigate neonatal healthcare-associated infection (HAI) risks.
• Further research is needed to address the observed increase in workload and sustain improvements in clinical outcomes.