1997 OPEN FORUM Abstracts
THE EFFECT OF FOURTEEN DAY CIRCUIT CHANGES ON VENTILATOR ASSOCIATED PNEUMONIA.
Mary Turley, RRT, John Votto, DO, Janet Brancifort, BS, RRT, M. Collins, RN, Hospital for Special Care, New Britain, CT.
Hospital for Special Care is a 200 bed chronic disease and rehabilitation hospital. With the steady growth of our ventilator dependent patient population and the need to provide quality cost effective patient care we reviewed all areas of our practice for improvement. This study compares the ventilator associated pneumonia (VAP) rates and cost reductions with 7 day vs 14 day circuit changes. Methods: During Phase 1 circuits were changed every 7 days and during Phase 2 circuits were changed every 14 days. Data was collected for 6 months during each phase. Infection Control monitored the occurrence of VAP during this period, using clinical criteria consistent with the CDC. Data was also obtained for ventilator circuit costs and practitioner time spent doing circuit changes. There was no change in mechanical ventilation practice during this time. Heated wire circuits and heat moisture exchange systems were used and patients were on a closed suction catheter system. Results: Based on 8,760 ventilator days (48 patients) in Phase 1 the VAP rate was 1.75/1000 ventilator days. Practioners spent 416 hours doing circuit changes and circuit costs were $25,444 during this time. In Phase 2 there were 10,950 ventilator days (60 patients) and the VAP rate was 1.64/1000 ventilator days. Practioners spent 260 hours doing circuit changes and circuit costs were $18,639. CONCLUSION: Our results would suggest, that in the long term ventilator dependent patient population, ventilator circuits can be changed at 14 day intervals without a significant change in the occurrence of VAP and with a significant savings in circuit costs and practitioner time.