Presentation number 30 - a journey to reduce possible ventilator associated pneumonia (pvap) infections in one intensive care unit


Aurora Health Care


BACKGROUND: Patients on mechanical ventilation are at risk for numerous complications including pneumonia, pneumothorax, acute respiratory distress syndrome, prolonged hospitalization and an increased risk of mortality. In 2013, the Centers for Disease Control and Prevention (CDC) released new guidelines in an effort to streamline the reporting process. The new definitions provided a standardized, more objective criterion in identifying possible ventilator-associated pneumonia (PVAP) cases and other ventilator-associated events (VAE). In 2014, our facility noted a significant increase in our ventilator-associated event data in our twenty-four (24)-bed Intensive Care Unit (ICU). In 2013, our PVAP rate was 1.03 (n = 1). In 2014, our PVAP rate increased to 4.85 (n = 8).

METHODS: In order to reduce our PVAP rates, a multidisciplinary workgroup was formed to review and evaluate research, evidence based practice, and national guidelines. The workgroup recognized this process required a joint effort between respiratory therapy and nursing. Core education was created and shared with each group. This was followed by audits to monitor for compliance to the bundled measure components of the education. The education focused on maintaining the head of bed at thirty (30) degrees, utilizing an endotracheal tube which included a suction lumen and evacuation port, oral care, and changing suction canisters and set-ups every 24-hours. We continued to track our ICU VAE rates, including PVAP rates, and reviewed all events at our monthly workgroup meetings. The monthly audit results were shared with the departments and the work team.

RESULTS: The 2015 data showed our year-to- date PVAP rate was 2.18 (n = 3). Our goal was to see a 50% reduction in this year's PVAP rate. The overall VAE rate data to date are shown in Table 1.

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CONCLUSIONS: The mandatory education provided to respiratory therapy and nursing, along with with monthly auditing for compliance, helped reduce and sustain our PVAP rate.

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