Hospital-acquired infections (HAIs) are a critical healthcare issue in the United States that has a poor influence on patient satisfaction and care outcomes. Trach infections are a common type of HAIs and are often the result of inadequate control during various manipulations, including suctioning (Nationwide Children’s Hospital [NCH], 2017). Research shows that it is possible for doctors and nurses to prevent trach infections and other HAIs using adequate precautions, such as hand hygiene and personal protective equipment (PPE) (Siegel, Rhinehart, Jackson, & Chiarello, 2007). Hence, the focal issue of the paper is the control of trach infections rate through standard precautions during suctioning. The primary population that will be considered as part of the quality improvement initiative includes pediatric patients from birth to adolescence. Observations In order to identify the prevalence of the issue in clinical settings, observations were carried out. A total of four observations of suctioning procedures were conducted, involving three nurses and one respiratory therapist. Each specialist who has been observed during the project had received training in infection control both during mandatory orientation and annually. All procedures were routine, which could have affected the staff’s attention to precautionary measures. Staffing levels during each observed shift were noted to evaluate whether understaffing had an effect on compliance. However, it is unlikely that staffing levels affected performance because all specialists showed similar precautionary behaviors. The results of observations showed that the use of precautions during suctioning was inconsistent. While all specialists followed the guidelines for hand hygiene, equipment checking, and patient assessments, none of them used a full set of PPE. This could create an additional risk of trach infection during suctioning (Siegel et al., 2007). A quality improvement initiative could have a positive influence on the staff’s compliance with infection control guidelines, thus addressing this risk. The Impact of Nursing The role of nurses in quality improvement in clinical settings is critical because nurses can promote best practices. First, they can implement best practices in their work, thus decreasing the rates of HAIs. On the other hand, they can observe other care providers’ compliance with guidelines and offer comments or suggestions for improvement. Nurses can also use their position and experience to draw the management’s attention to important issues in clinical practice, including HAIs rates (Strech & Wyatt, 2013). Hence, it is critical to target nurses as part of the quality improvement initiative to achieve great results. Literature Review of Best Practices In order to design a quality improvement initiative, one should identify tools and mechanisms that assist in the reduction of HAIs. A literature review of various guidelines and research studies was performed to identify the key themes in HAIs prevention with a specific focus on trach prevention. As a result of literature analysis, five key topics emerged: hand hygiene, personal protective equipment, supervision, and organizational environment. Hand Hy