Ventilator-associated pneumonia is the second most common nosocomial infection affecting critically ill patients. Incidence of VAP and related complications extend patients’ duration of mechanical ventilation and increase intensive care, hospital length of stay, costs and mortality risk. An increase in antibiotic use is also commonly associated with VAP. In 2017, NYC Health + Hospitals/Bellevue began its Ventilator-Associated Pneumonia in Adult Trauma Patients initiative to reduce the rate of VAP in adult trauma patients by achieving a culture change through multidisciplinary effort and empowerment.
Interventions implemented through the initiative included execution of a ventilator bundle, creation of an oral care tracking system, adoption of an analgesia/sedation guideline and the use of a tracking tool to monitor compliance and enable real-time feedback. This project followed the Six Sigma methodology by using the DMAIC (define, measure, analyze, improve, control) steps. Making the program a success required efforts by all staff, including the trauma program, intensive care unit physicians, ICU nursing, infection control and respiratory therapy.
As a result of this initiative, compliance with the ventilator “bundle” of care protocols increased from 93% to 100%. All ICUs in the hospital now use a standard ventilator bundle on all mechanically-ventilated patients.
NYC Health + Hospitals/Bellevue was recognized with HANYS’ 2019 Pinnacle Award for Quality and Patient Safety for this successful program. Watch our video for an in-depth look at this initiative and its results.
For more information, contact Margaret Ewen, MS, PA-C, trauma performance improvement coordinator, at (212) 562-8313 or firstname.lastname@example.org.