Ventilator-associated pneumonia (VAP) may be virtually gone from United Hospital in St. Paul, Minnesota, but it’s ever-present in discussions among staff there. “We talk about it every day during multidisciplinary rounds,” says Maureen Smith, RN, MSN, CCNS, Clinical Nurse Specialist in the ICU. “Our infection control staff have been very resourceful in finding ways to keep it fresh in our minds.”
“You can’t let it go,” agrees Marge Van Roekel, RN, BSN, CCRN, Operations Leader for Critical Care. “You have to stay vigilant. We are always evaluating our outcomes and tinkering with our processes to continue improving.” Tools that support effective ongoing attention to preventing VAP include special forms used during rounds that highlight the steps in the Ventilator Bundle; a critical care training course for new staff members that educates them on the proper procedures for ventilated patients; and visual cues such as a reminder sign that is only visible if the head of the patient’s bed is at the wrong angle.
Staff at United know from experience how important ongoing vigilance is. “We celebrated when one of our ICUs reached a whole year with no cases of VAP,” says Van Roekel. “The next week, we got one.” Many ICU professionals can identify with this experience, which shows just how challenging it is to keep VAP at bay.
02/01/2007
