Download Ventilator-Associated Pneumonia (VAP)

Evelyn Mello, BSMT, (ASCP) MS, CIC
Infection Control Practitioner
Ventilator-Associated Pneumonia
MetroWest Medical Center’s Journey
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MWMC is a 2-hospital system
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Framingham Union Hospital in Framingham
Leonard Morse Hospital in Natick
269 bed community teaching hospital
2 critical care units, total of 21 beds
24/7 Intensivist / Pulmonologist ICU / CCU coverage
4 days average length of stay on ventilator
Ventilator-Associated Pneumonia
Project
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Background
in 2005 – IHI 100K Lives Campaign
 Review of our VAP rates –
 Started
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In 2004 – 4 VAP cases, 2.8/1000 vent. days
 VAP
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Bundle and education / Implementation
Aim
 Reduce
VAP at MWMC to 0% within 1 year
Ventilator-Associated Pneumonia
Project
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Multidisciplinary Team Approach
 ICU/CCU Staff, Respiratory Therapy, Intensivists, Infectious Disease
MDs, Infection Control Practitioners, Pharmacy, Quality
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Developed VAP Bundle Checklist and signage
 Additional Interventions
 Increased use of non-invasive ventilation – CPAP
 Chlorhexidine Mouthwash
 Spontaneous breathing trial done on all vent. patients daily
 Fast-track all vent. patients – wean and extubate quickly
 Resp. staff monitoring of VAP bundle with vent. checks (q 2 hours)
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Lessons Learned
 Teamwork leads to Positive Patient Outcomes & Quality Patient Care
MetroWest Medical Center
Ventilator Associated Pneumonia
# VAP Cases
VAP Rate per 1,000 vent days
5
2004 - Baseline
2005 - VAP Bundle
Implemented (Education)
4
4
2006 - 2007
Maintained 50% decrease from
baseline
3
2.80
2008 - Q1 2009
100% decrease from
baseline
2
2
2
1
1.00
1.20
1
0.40
0.00
0
0.00
0
0
2004
2005
2006
2007
2008
2009 Quarter 1