The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

USING ORAL CARE POLICY TO REDUCE OR PREVENT VENTILATOR ASSOCIATED PNEUMONIA IN THE LONG TERM ACUTE CARE HOSPITAL SETTING.

Cheri A. Duncan, Nancy Rhodes, Kelli Terpstra; Cardiopulmonary, Baylor Specialty Hospital, Dallas, TX

BACKGROUND: With hospital acquired infections being a contributing cause of death in the United States, hospitals are seeking employable techniques for staff to use in combating this issue. Research studies have been conducted on the prevalence and prevention of Ventilator Associated Pneumonia (VAP) through interventions such as patient positioning, prevention of aspiration and oral care. At Baylor Specialty Hospital, a Long Term Acute Care Facility, we examined the use of and oral care policy and procedure (PnP) that incorporated risk scoring, associated interventions such as compressive oral care and vigilant respiratory care assessment. METHOD: A non-experimental retrospective analysis of ventilator days and reported VAP cases was conducted for a six year period. All subjects included in the study were 18 years of age or greater. Those included in the analysis required long term ventilator management and had a tracheostomy on admit to the facility. The PnP included a risk scale that allowed for scoring patients regarding their respiratory acuity. According to the patients score assigned interventions such as comprehensive oral care and respiratory assessments were provided. RESULTS: Results of the retrospective review revealed that the VAP rate prior to the review for our facility was < 20% for 2003. Rates are calculated using the National Healthcare Safety Network and Center for Disease Control, reflecting a national method for VAP surveillance and calculation. Upon implementation of the PnP in 2004 only one case of VAP was identified the first year of the review. The remaining 5 years revealed a 0% VAP rate. January 2004 to December 2010 there were 6261 ventilator days. CONCLUSIONS: VAP can be reduced with a comprehensive oral care PnP. The success BSH has demonstrated with a 0% VAP rate is attributable to strict adherence to its specific oral care policy and multidisciplinary approach that encourages staff accountability with resulting improved patient outcomes. Sponsored Research - None