1. TIPQC: Tennessee Initiative for Perinatal Quality Care Aim: Improve Tennessee Morbidity and Mortality Mission: Design and implement data-driven, provider level statewide QI projects Member stakeholders: – Neonatologists, MFM, OB, Family Practice – RN, NPs, nurse midwives, lactation consultants – Hospital administration, Payers, Government – Families, Advocacy Groups, Community Groups

2. The NICU CLABSI Challenge <22 wks 23-26 wks 27-34 wks 34-36 wks 37-38 wks>39 wks * < 750 grams751-1000 grams1001-1500 grams1501-2500 grams>2500 grams 3.83.31.72.40.9

3. Vermont Oxford Network 2007 Infants <1500gm with any nosocomial infection Our patients are different… …but so are our NICUs. Some NICUs have far fewer nosocomial infections Some NICUs have far fewer CLABSI episodes

4. TIPQC CLABSI Project Similarities Hand Hygiene Full barrier (right size!) Insertion Bundle Line Carts Maintenance bundle Post results Investigate episodes Culture Change Differences Remove line when… Companion Project HBM4VLBW Balancing measures

5. NICU Balancing Measures CLABSI -Morbidity -Mortality -LOS -Cost Growth Failure Other infection NEC PNALD Osteopenia

6. TIPQC CLABSI Project Similarities Full barrier (right size!) Checklists Line Carts Maintenance bundle Post results Investigate episodes Culture Change Differences Remove line when… Companion Project HBM4VLBW Balancing measures – Necrotizing Enterocolitis – Growth – Other infection Congenital Malformations – GI atresias – Abdominal wall

7. What can you do? If you have a NICU, find your TIPQC team! Ask about the Temperature Project Ask if your NICU uses central lines Share your TPSC CLABSI report Sponsor your NICU’s participation www.TIPQC.org Project application TIPQC.office@tipqc.org