The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

AGGRESSIVE ORAL CARE IN THE FIGHT AGAINST VENTILATOR ASSOCIATED PNEUMONIA IN CHILDREN ON LONG-TERM MECHANICAL VENTILATION.

Tretha A. Hewett1, Kelli Terpstra2; 1Cardiopulmonary, Our Children's House at Baylor, Dallas, TX; 2Nursing, Our Children's House at Baylor, Dallas, TX

BACKGROUND: Ventilator associated pneumonia (VAP) is among hospital infections with the most preventable death. 3 VAP’s high burden of disease and costs of care have made it a high priority in numerous national patient safety campaigns. At Our Children’s House at Baylor (OCH) we determined that the use of a pediatric VAP bundle inclusive of an aggressive oral care policy and procedure (PnP) implemented in pediatric long term acute care setting, in conjunction with a comprehensive oral care kit, can drastically reduce the number of reported VAP cases. METHOD: A retrospective analysis of ventilator days and reported VAP cases were done during a 6 year period. All patients included in the study were 3 months -18 years of age. Those included in the analysis required long term ventilator management and had a tracheostomy on admit to the facility. RESULTS: During the six year period from January 2005 to December 2010 there were 11,811 ventilator days. There was three recorded case of VAP in June 2006. Since July 2006 our VAP rate has been documented at 0%. CONCLUSIONS: VAP can be reduced with a comprehensive Pediatric VAP Bundle and oral care PnP. With the characteristics of our special patient population including their multiple problems and comorbidities and working with family members adhering to our practice model while learning to care for their child, we need to ensure infection control standards are met. This patient care model for us increases the probability of VAP. This makes the success of OCH has demonstrated with a 0% VAP rate even more remarkable. We attribute this to strict adherence to our very specific Pediatric VAP Bundle and oral care policy. The multidisciplinary approach also encourages all to be accountable for their part in oral hygiene and upholding the success of the facility and phenomenal patient outcomes. Patients with tracheotomies afford the clinician easier opportunity for effective oral hygiene thus reducing the possibility of bacterial load. Sponsored Research - Received a non-restricted educational grant from Sage Products.