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    Qi Group Project

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    This quality improvement project aims to reduce ventilator-associated pneumonia (VAP) rates in intensive care units. VAP is the most common infection in ICUs and increases mortality, morbidity, and costs. The plan is to identify issues with current prevention practices, educate staff, and implement a new VAP bundle. This involves engaging all departments, evaluating current practices like oral care and positioning, analyzing data on prevention strategies, addressing contributing factors, and establishing committees and audits to ensure the new practices are followed. Implementing a VAP bundle focusing on sedation, readiness to extubate, conditioning, oral care, suctioning, head elevation, and ventilation has reduced VAP rates and saved over $10 million.

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    Qi Group Project

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    This quality improvement project aims to reduce ventilator-associated pneumonia (VAP) rates in intensive care units. VAP is the most common infection in ICUs and increases mortality, morbidity, and costs. The plan is to identify issues with current prevention practices, educate staff, and implement a new VAP bundle. This involves engaging all departments, evaluating current practices like oral care and positioning, analyzing data on prevention strategies, addressing contributing factors, and establishing committees and audits to ensure the new practices are followed. Implementing a VAP bundle focusing on sedation, readiness to extubate, conditioning, oral care, suctioning, head elevation, and ventilation has reduced VAP rates and saved over $10 million.

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    This quality improvement project aims to reduce ventilator-associated pneumonia (VAP) rates in intensive care units. VAP is the most common infection in ICUs and increases mortality, morbidity, and costs. The plan is to identify issues with current prevention practices, educate staff, and implement a new VAP bundle. This involves engaging all departments, evaluating current practices like oral care and positioning, analyzing data on prevention strategies, addressing contributing factors, and establishing committees and audits to ensure the new practices are followed. Implementing a VAP bundle focusing on sedation, readiness to extubate, conditioning, oral care, suctioning, head elevation, and ventilation has reduced VAP rates and saved over $10 million.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    40 views12 pages

    Qi Group Project

    Uploaded by

    api-457485362
    This quality improvement project aims to reduce ventilator-associated pneumonia (VAP) rates in intensive care units. VAP is the most common infection in ICUs and increases mortality, morbidity, and costs. The plan is to identify issues with current prevention practices, educate staff, and implement a new VAP bundle. This involves engaging all departments, evaluating current practices like oral care and positioning, analyzing data on prevention strategies, addressing contributing factors, and establishing committees and audits to ensure the new practices are followed. Implementing a VAP bundle focusing on sedation, readiness to extubate, conditioning, oral care, suctioning, head elevation, and ventilation has reduced VAP rates and saved over $10 million.

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    Quality Improvement Project

    Ventilator Associated Pneumonia


    (VAP)

    Courtney Whyte
    Addelyn Villalobos
    Sydney Wren
    Anna Lusnia
    Landon Howard
    The Problem

    Ventilator Associated Pneumonia (VAP)1

    ● Most common infection in Intensive Care Units (ICU)


    ● Increased rate of mortality and morbidity
    ● Large hospital costs
    ● Practice compliance
    The Plan: Goals & Objectives

    Goal:
    Reduce the number of patients acquiring VAP

    Objectives:

    ● Identify problematic areas in current practice


    ● Educate all health care team members
    ● Implement new protocol for VAP prevention
    Do: Involve The Entire
    Interprofessional Team

    ● Physicians
    ● Nurses
    ● Respiratory Therapists
    ● Physical Therapists
    ● Patient Care Technicians
    ● Pharmacists
    ● Facility Management Representatives
    ● Risk Management
    Do: Evaluate Current Practice2

    Nursing Interventions
    ● Regular oral care
    ● Subglottic suctioning
    ● Position and mobility maintenance
    Physician Practice
    ● Minimize ventilation whenever possible
    Management Practice
    ● Ensure adequate staffing
    Study: Analysis of Data3

    Regular Oral Care

    ● Prevents colonization in the upper airway


    ● Reduces risk of VAP 67- 72%

    Subglottic Suctioning

    ● Removes pooling secretions above ETT cuff


    ● Increases time to first VAP by 2.6 days
    Study: Analysis of Data3

    Position and Mobility Maintenance

    ● Elevate head of bed to reduce aspiration


    ● Shown to lower the chance of VAP by 26%

    Minimize Ventilation

    ● Non-invasive positive pressure ventilation


    ● Shown to lower risk of VAP
    Study: Contributing Factors4

    ● Resources and supplies


    ● Compliance
    ● Education
    ● Collaboration
    ● Systematic Intervention
    ● Widespread implementation
    Act: VAP Bundle5

    ● Minimize sedation
    ● Assess readiness to extubate daily
    ● Maintain and improve physical conditioning
    ● Regular oral care
    ● Subglottic suctioning
    ● Elevate head of bed
    ● Minimize ventilation
    Act: VAP Reduction

    Since initiation of the VAP bundle:6

    VAP rates dropped from 10.2 cases/1000 ventilator days to


    3.4 cases/1000 ventilator days and it saved facilities an
    estimated $10.8 million
    Act: Ensuring New Practices

    Establishing committees dedicated to VAP prevention

    ● Committees comprised of healthcare members in each unit

    Quarterly audits

    ● Inspection of appropriate usage of VAP prevention bundles


    ● Data used for further improvement

    Real-time computerized dashboard7

    ● Initiates instant correction of noncompliant parameters


    References
    1. Abd-Elmonsef, M. M., Elsharawy, D., & Abd-Elsalam, A. S. (2017). Mechanical ventilator as a major cause of
    infection and drug resistance in intensive care unit. Environmental Science and Pollution Research,25(31),
    30787-30792. doi:10.1007/s11356-017-8613-5
    2. American Nurses Association. (2017). 5 nursing strategies to prevent ventilator-associated pneumonia. Vol
    12(6). Retrieved from https://www.americannursetoday.com/5-nursing-strategies-prevent-ventilator -associated-
    pneumonia/
    3. Keyt, H., Faverio, P., & Restrepo, M. I. (2014). Prevention of ventilator-associated pneumonia in the intensive
    care unit: a review of the clinically relevant recent advancements. The Indian Journal of Medical Research,
    139(6), 814-21.
    4. Rodrigues, Ana Natesia, Fragoso, Luciana Vládia e Cavalhedo, Beserra, Francisca de Melo, & Ramos, Islane
    Costa. (2016). Determining impacts and factors in ventilator-associated pneumonia bundle. Revista Brasileira de
    Enfermagem, 69(6), 1108-1114. https://dx.doi.org/10.1590/0034-7167-2016-0253
    5. Klompas, M., Branson, R., Eichenwald, E.C., Greene, L.R., Howell, M.D., Lee, G., Magill, S.S., Maragakis, L.L.,
    Priebe, G.P., Speck, K., Yokoe, D.S., & Berenholtz, S.M. (2014). Strategies to prevent ventilator-associated
    pneumonia in acute care hospitals: 2014 update. Infection Control and Hospital Epidemiology, 35(8), 915-936
    6. Bird, D., Zambuto, A., O’Donnell, C., Silva, J., Korn, C., Burke, R., Burke, P., & Argarwal, S. (2010). Adherence
    to ventilator-associated pneumonia bundle and incidence of ventilator-associated pneumonia in the surgical
    intensive care unit. Arch Surg, 145(5):465–470. doi:10.1001/archsurg.2010.69
    7. Talbot, T., Carr, D., Lee Parmley, C., Martin, B., Gray, B., Ambrose, A., & Starmer, J. (2015). Sustained Reduction of
    Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator Bundle
    Compliance Dashboard. Infection Control & Hospital Epidemiology, 36(11), 1261-1267. doi:10.1017/ice.2015.180

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