No VAPs – It CAN Be Done!
Advocate Health Care
Oak Brook, Illinois, USA
Team
Scott Saran, MD, Advocate Health Centers
Steve Sokalski, DO, Christ Medical Center
Connie Cutler, Oak Brook Support Center
Elona MacLeod, Oak Brook Support Center
John Alban, Illinois Masonic Medical Center
Jane Bechtold, South Suburban Hospital
Beth Beck, Christ Medical Center
Zein Bertacchi, Good Shepherd Hospital
Teresa Chou, Illinois Masonic Medical Center
Susan Cienkus, South Suburban Hospital
Mike Costello, PhD, ACL Laboratories
Diane Dickens Bethany Hospital
Kathleen Dorich, Advocate Home Health
Lori Ellerman-Roark, Touhy Support Center
David Gascoigne, Supply Chain Management
Sharon Gerc, Touhy Support Center
Marge Gribogiannis, Lutheran General Hospital
Lynn Guibourdanche, Lutheran General Hospital
Janet Havel, ACL Laboratories
John Hunter, ACL Laboratories
Wilfred Jean-Jacques, MD, Trinity Hospital
Lynwood Jones, MD, Good Shepherd Hospital
Rene Karon, Good Samaritan Hospital
Mark Kiezel, Lutheran General Hospital
Louise Kuhny, Good Samaritan Hospital
David Lucks, MD, Dreyer Medical Clinic
Jim Malow, MD, Illinois Masonic Medical Center
Karen Martin, Christ Medical Center
Beth Navarro, Advocate Health Centers
Emmy Lou O'Connor, Good Samaritan Hospital
Nianci Pan, Trinity Hospital
Darin Roark, Supply Chain Management
Lisa Russell, MD, Bethany Hospital
Rene Santos, MD, South Suburban Hospital
Jay Schamberg, MD, ACL Laboratories
Sally Schlatter, Lutheran General Hospital
Jo Sheehan, Good Shepherd Hospital
Shari Springs-Phillips, MD, Touhy Support Center
Julie Stamos, MD, Lutheran General Hospital
Terra Suriano, Lutheran General Hospital
Adam Treitman, Christ Medical Center
David Waitley, MD, Good Samaritan Hospital
Pamela Warnick, MD, Advocate Health Centers
Aim
To decrease the incidence of ventilator-associated pneumonia (VAP) per 1,000 ventilator days to zero.
Measures
Changes
Sites implemented the following change initiatives:
- Implementing an oral care protocol every 2-8 hours for all patients on mechanical ventilation.
- Enlisting all staff (bedside nurses to dietary) to monitor keeping the head of bed elevated.
- Utilizing the Ventilator Bundle Checklist to begin to monitor compliance with all interventions (via the eICU).
Results
 
Summary of Results / Lessons Learned / Next Steps
- Involve associates in the change process.
- Provide unit specific data to associates in order to demonstrate their involvement does have an impact.
- Celebrate your success – two articles have been published on the VAP study:
- Schleder B, Stott K, Lloyd R. The effect of a comprehensive oral care protocol on patients at risk for ventilator-associated pneumonia. J Advocate Health Care. Spring-Summer 2002;4:27-30.
- Cutler C, Davis N. Improving oral care in patients receiving mechanical ventilation. Am J Crit Care. 2005:14:389-394.
- Share your process and results with other institutions.
- Educate new staff regarding expectations and re-monitor.
Contact Information
Cindy Welsh, RN, MBA, Administrator Clinical Excellence
Advocate Health Care
cindy.welsh@advocatehealth.com
[Storyboard presentation at IHI's National Forum, December 2005]
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