The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

REDUCING VENTILATOR-ASSOCIATED PNEUMONIA

Ava J. Dobin, BSN, CIC, Janette Moss, RN, MSN, Coral Springs Medical Center, Coral Springs, Florida. Although Pneumonia is a risk faced by any patient being admitted to a hospital, when patients are placed on a ventilator, the risk increases from 3 to 10-fold. The Critical Care Unit at Coral Springs Medical Center (CSMC) experienced 14.9 cases of Ventilator-Associated Pneumonia (VAP) per 1,000 ventilator days in 2001 and 19.9 cases in 2002, exceeding the Center for Disease Control’s (CDC) median rates of 4.2 to 16.3. Subsequently, the team established a data collection plan to gather baseline measurements on these areas. The data was displayed in Pareto charts, histograms, run and control charts. Performance benchmarks served as the basis for further root cause identification. Our practices for providing oral care did not meet the best practices identified in evidence-based protocols. Our team chose three processes to trial. The top three products included a homegrown oral care product and the products from two different vendors. The two vendor-based products were trialed for comparison and assessed against an array of factors considered critical to quality. Our team used multi-voting to find the highest priority for product use. We saw 100% standardization in the technique, times, and overall process. The financial impact to the organization was striking, since the cost of VAP over the fiscal year was over $800,000! CSMC achieved 1.9 cases per 1,000 ventilator days in 2003 – an 89% reduction in VAP, and well below the median rates published by the CDC. Our goal was to reduce the incidence rate to at most 10% - but we surpassed our goal. CSMC achieved 0% VAP incidence rates for the last twelve (12) consecutive months.

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