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CS27
Changing The Rise Of Ventilator Associated Pneumonia In The ICU's
By: Harner, A.; Tampa General Hospital, Tampa,FL
For further information, please contact: aharner@tgh.org
Purpose: High acuities and a large number of patients requiring prolonged ventilator assistance had led to an unacceptable rise in the incidence of ventilator associated pneumonia. It was decided to develop a method of treatment to reduce and/or eliminate this expensive and often lethal complication.
Description: Initially, the guidelines from the Institute for Healthcare Improvement were used in our Medical Intensive Care Unit. We developed a seven-item list, which was posted in the chart of every patient on the ventilator. Doctors were asked to write these items as orders, which were then implemented by the nursing staff. A small sign denoting the “Vent Bundle” was posted at the patient’s room door as a staff reminder. Charts were audited three times a week for compliance and the Infectious Disease nurse followed the incidence of pneumonia. We purchased and began using a mouth-care package that contained all items necessary for a twenty-four hour period. Following the implementation of the bundle, our unit had seven months with no ventilator associated pneumonia.
Evaluation/Outcomes: With the success of this plan, it was decided to implement it in all units. Our incidence of ventilator associated pneumonia has decreased dramatically and we have added the bundle to a full set of orders for the adult ventilator patient. We are in the process of incorporating these orders into standard order sets for other units. At this time, our “Bundle Committee” meets bi-monthly to evaluate the success of this house-wide program.
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