This study seeks to translate evidence-based practices in nosocomial infection in order to drive implementation of these practices into hospitals to reduce infection, decrease hospital costs and improve patient outcome. This study will attempt to identify predictable barriers and existing culture in order to increase success in implementing change strategies through development of tools to facilitate application of evidence-based practices. The proposal stems from an ongoing collaboration across the Greater Cincinnati metropolitan area stimulated by the Greater Cincinnati Health Council and the VA GAPS Center in an effort to improve safety and reduce injury to patients in Cincinnati.