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Evelyn Mello, BSMT, (ASCP) MS, CIC Infection Control Practitioner Ventilator-Associated Pneumonia MetroWest Medical Center’s Journey MWMC is a 2-hospital system 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 Background in 2005 – IHI 100K Lives Campaign Review of our VAP rates – Started In 2004 – 4 VAP cases, 2.8/1000 vent. days VAP Bundle and education / Implementation Aim Reduce VAP at MWMC to 0% within 1 year Ventilator-Associated Pneumonia Project Multidisciplinary Team Approach ICU/CCU Staff, Respiratory Therapy, Intensivists, Infectious Disease MDs, Infection Control Practitioners, Pharmacy, Quality 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) 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