Skip to main content

Advertisement

  • Poster presentation
  • Open Access

Quality improvement: reducing ventilator-associated pneumonia

  • 1,
  • 1,
  • 1 and
  • 1
Critical Care200812 (Suppl 2) :P432

https://doi.org/10.1186/cc6653

  • Published:

Keywords

  • Public Health
  • Pneumonia
  • Emergency Medicine
  • Quality Improvement
  • Preventative Intervention

Introduction

Ventilator-associated pneumonia (VAP) is associated with increased morbidity in intensive care [1]. Education and checklists may improve adherence to preventative interventions [2].

Methods

A 'VAP prevention bundle' was introduced in November 2005. Bundle compliance was assessed 1 year later (50 patients) and twice again (59 and 50 patients) after introduction of an educational package. The incidence of VAP was concurrently measured using HELICS definitions [3].

Results

VAP rates and bundle compliance were unaffected by passive bundle introduction. However, compliance increased following the intervention. The quarterly VAP incidence fell from 24 to 6/1,000 patient-ventilated days. There was a significant increase in the number of 'at-risk ventilated patient-days' between each incidence of VAP. See Table 1 and Figure 1.
Table 1

Bundle compliance

 

Compliance (%)

Ineligible (%)

Patients (%)

 

November 2006

May 2007

October 2007

Head up

54

79

95

Oral wash

2

100

100

Subglottic tube

55

89

93

Daily weaning plan

54

64

65

Daily sedation break

56

90

82

Figure 1
Figure 1

Ventilator-associated pneumonia (VAP) geometric distribution chart.

Conclusion

Passive introduction of the bundle had limited effect as demonstrated by initial compliance. Compliance improved following education. Improved compliance was associated with a decreased incidence of VAP.

Authors’ Affiliations

(1)
Stirling Royal Infirmary, NHS Forth Valley, UK

References

  1. Heyland DK, et al.: Am J Respir Crit Care Med. 1999, 159: 1249-1256.PubMedView ArticleGoogle Scholar
  2. Evidence Report/Technology Assessment[http://www.ahrq.gov/downloads/pub/evidence/pdf/qualgap6/hainfgap.pdf]
  3. HELICS[http://helics.univ-lyon1.fr/home.htm]

Copyright

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

Advertisement