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

The NICU CLABSI Challenge

<22 wks 23-26 wks23-26 wks 27-34 wks27-34 wks 34-36 wks 37-38 wks >39 wks*

< 750 grams

751-1000 grams

1001-1500 grams

1501-2500 grams

>2500 grams

3.8 3.3 1.7 2.4 0.9

Vermont Oxford Network 2007Infants <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

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

NICU Balancing Measures

CLABSI-Morbidity-Mortality-LOS-Cost

Growth FailureOther infectionNECPNALDOsteopenia

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

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