1. Linda Huddleston, RN, MSN, MPHc Director of Infection Prevention Robin Cater, RN, BSN, CCRN Clinical Educator Critical Care/Cardiac Care Stepdown Unit

3. On the CUSP Adventure In 2009, ICU and CCU had a combined CLABSI rate of 1.06 We wanted to get to zero – but how could we get there?

4. Enlightened Denise Flook contacted Infection Preventionists in Georgia and Enlightened them about a project from Johns Hopkins…. “On the CUSP” ( Comprehensive Unit-based Safety Program)

5. Peter Pronovost One doctor, motivated by a high profile pediatric death at Johns Hopkins, led the charge that launched a persistent effort to "transform" that culture and improve patient safety.

6. Engaged A CLABSI Prevention team was formed Included representation from: ICU, CCU, ECC, anesthesia, Infection Prevention, staff nurses, PICC nurse, CNO, Director of OR, Medical Resident &Director of Residency, Vascular Liaison, and an ID consultant

7. Engaged Surveyed staff (60% completed) Created a central line bundle Educated staff Central line checklist Ask daily if catheter can be removed (revised daily goal tool) Empowered nurses to SPEAK UP!

8. Encouraged Denise Flook, Peter Provonost Coaching and content calls Each month we were at zero: Celebrations Intranet Signs in units

9. Empowered Coached Staff to set an example and be Pro-active Any staff can stop the procedure Currently working on creating a Culture of Safety with a “Speak Up” program.

10. Evaluated “Assumed” that everyone knew what a “head to toe” dressing was- discovered that we had a 46” drape “Assumed” that checklists were being completed at the bedside-EMR was being used post-procedure Physicians are using more Picc lines now with CVP monitoring capacity

11. Getting to…… January 2010- last CLABSI ICU…until August 2011….. January 2008 –last CLABSI CCU