2005 OPEN FORUM Abstracts
OUTCOMES OF A VENTILATOR BUNDLE TRACKING SYSTEM
Ted Bond RRT, Steve Abplanalp BS RRT, Terry Clemmer MD, Vrena Flint MBA RRT, Loren Greenway PHD RRT, Jim Hamilton RRT, John Holmen PHD, Tupper Kinder BS, Vicki Spuhler MSN. Intermountain Health Care (IHC) Hospitals, Salt Lake City, UT, USA
Background: Ventilator Acquired Pneumonia (VAP) was a concern for us as healthcare professionals. Reducing ventilators days by twenty five percent was a Board Goal. We wanted a system to measure the compliance of our ventilator bundle components that could be used across multiple facilities. The measurement process would enable us to track compliance, communicate with the team, get the patient back into compliance, and thus prevent VAP and reduce ventilator days.
Method one: Patient Paper Documentation Method one was a paper process in which data was gathered twice per week. The Registered Nurse (RN) collected data to determine compliance of the ventilator bundle protocol. If the patient was out of compliance, the RN communicated with the team to assure patient compliance.Method two: Patient Documentation Computerized ProtocolMethod two was a computerized process in which the Respiratory Care Practitioner (RCP) chartsthe ventilator bundle compliance with each ventilator/patient assessment (approximately every twohours.)RCP responds to computer questions that are asked with each ventilator/patient assessment:
§ Is the patients Head of Bed (HOB) > 30 degrees?
§ Is the patient on a sequential compression device?
§ Did the patient have a sedation vacation since the last ventilator/patient assessment?Measured Outcomes: With method two, a ventilator bundle compliance report can be acquired on any patient, any unit, at any of the ten computerized hospitals across the IHC system at any time. Also, data reports can be acquired monthly for VAP and ventilator days. These reports enable us to monitor the outcomes. Results: With the ventilator bundle tracking system, the VAP rate in the IHC system reduced thirty percent in the first quarter and the ventilator days reduced by twenty five percent.
Conclusion: The data suggests that using the ventilator bundle documentation with the ventilator/patient assessment surpasses the other methods. The multidisciplinary involvement of Physicians, RCPs, RNs, and Information Systems was key to our success. We believe we can continue to decrease ventilator days by continuing to measure the compliance with the ventilator bundle protocol and a high level of confidence that we are doing what we can to prevent VAP.