The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

A NOVEL METHOD FOR TRACKING AND ANALYZING VENTILATOR PATIENT HOMOGENEITY BY A VENTILATOR MANAGEMENT TEAM.

John Emberger BS RRT, Steve Connel BA RRT, Herbert Patrick MD. Department of Pulmonary Care, Thomas Jefferson University Hospital Inc., Philadelphia, PA

INTRODUCTION: Analyzing respiratory care ventilator workload and setting up ventilator educational strategies requires data. Traditionally, the number of ventilator patients, ventilator days and the average ventilator length of stay (ALOSv) have been examined as a hospital wide number. These would be representative if ventilator patients were homogeneous hospital wide. Our Ventilator Management (VentMan) Team analyzes daily data on all ventilator patients with bedside computers and educates about ventilator management. HYPOTHESIS: We wanted to analyze the homogeneity of intensive care unit ventilator patients with a ventilator patient tracking system (VentMan). Methods: The number of adult ventilator patients and ALOSv for adult ICU's were examined over a six month period (Jul96 - Dec96) from the VentMan database. Data was sorted by ICU: Medical Respiratory (MRICU), Surgical (SICU), Neurosensory (NICU), and Cardiac Care (CCU). Four ventilator length of stay groups (LOSv) were identified: < 4 days, 4 to 13 days, 14 to 24 days, and >= 25 days. The data was also sorted by percent of patients (within each ICU) in each of the four LOSv groups. Results:

Intensive Care Unit Data from Jul96 - Dec96 (% indicates percentage within each ICU)

MRICU SICU NICU CCU Total

Ventilator Patients 124 138 177 240 679

ALOSv, days 13.26 7.34 8.70 3.97 7.58

% with LOSv < 4 28% 59% 53% 72% 56%

% with LOSv 4 to 13 49% 29% 25% 23% 30%

% with LOSv 14 to 24 11% 4% 2% 3% 7%

% with LOSv >= 25 12% 8% 10% 2% 7%

Conclusions: A wide range of ALOSv between ICU's (3.97 to 13.26 days) is demonstrated which represents varied ventilator patient populations separated by ICU. The wide ALOSv range between ICU's is due to varied numbers of long LOSv (i.e. >= 14 days) versus short LOSv (i.e. < 14 days). Analysis of the data helps our institution focus education about 'quick extubation' patients for certain ICU's and weaning the 'difficult to wean' patients for other ICU's. A single hospital wide ALOSv value or trend is not a good representation of ventilator patients since there is not homogeneity between ICU's. Trends on specific populations within ICU's are necessary to accurately analyze ventilator patients.

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