Leading and Sustaining Change : The Michigan Experience

Purpose:
Contrary to popular belief, Hospital Acquired Infections (HAI) are not necessarily unavoidable events in the ICU. By applying best practice strategies to combat the likelihood of acquiring care induced infections, thousands of lives can be saved each year.

Significance:
Ventilator associated pneumonia (VAP), catheter related Blood stream infections (CR-BSI) and catheter related urinary tract infections (CR-UTI)are a common problem in all ICU's. Despite common knowledge of efforts to address rates of infection, ICU's continue to struggle to decrease rates.

Strategy and Implementation:
By changing the safety culture of the organization and by applying best practice evidence to bedside care delivery in a thoughtful and systematic approach, the state of Michigan has decreased the incidence of ICU hospital acquired infections dramatically in the state. The Michigan Hospital Associations Patient Safety Organization has supported the efforts of healthcare organizations in the state by facilitating a collaborative team approach throughout all ICU's in Michigan. Northern Michigan Regional Hospital is one organization that has teamed exceptionally well with MHA and has utilized the tools initiated by Johns Hopkins Medical Center with great success in decreasing ICU acquired infections.

Evaluation:
The project, which was begun in 2004, has decreased the incidence of ICU ventilator associated pneumonia to zero in 2010, central line associated infections to zero in three years and catheter related urinary infections to 1 in 2010.

Implications for Practice:
By replicating strategies and tactics of our implementation, other organizations will see a decrease in hospital acquired infections. Both resources and best practices will be identified.