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How-to Guide: Prevent Ventilator-Associated Pneumonia
This How-to Guide describes key evidence-based care components of the IHI Ventilator Bundle which has been linked to prevention of ventilator-associated pneumonia.
Changes to Prevent Healthcare-Associated Infections
Organizations must test and implement changes to existing processes in order to prevent healthcare-associated infections (HAIs).
Using Care Bundles to Improve Health Care Quality
This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
Contra Costa Regional Medical Center: Where the Rate of VAP Dropped By More Than 90 Percent through Collaborative Efforts
At Contra Costa, a conscious effort from the top down and the bottom up creates a culture of collaboration and teamwork. Teamwork has enabled improvement of care processes and patient outcomes in many areas, including VAP.
Profiles in Improvement: Katharine Luther, Vice President, IHI
IHI Vice President Kathy Luther describes her career in health care quality improvement, and how her current IHI work includes getting finance and clinicians to work together to impact cost and quality.
Ventilator Bundle Compliance
Compliance with the Ventilator Bundle is defined as the percentage of intensive care patients on mechanical ventilation for whom all four of the elements of the Ventilator Bundle are documented on daily goals sheets and/or elsewhere in the medical record.
Ventilator-Associated Pneumonia (VAP) Rate per 1,000 Ventilator Days
Ventilator-associated pneumonia (VAP) is defined as pneumonia in a patient intubated and ventilated at the time of or within 48 hours before the onset of the event. (There is no minimum period of time that the ventilator must be in place in order for the pneumonia to be considered ventilator-associated.) The VAP rate is defined as the number of ventilator-associated pneumonias per 1,000 ventilator days
How-to Guide: Prevent Ventilator-Associated Pneumonia (Pediatric Supplement)
This How-to Guide specifically tailored for pediatrics describes key evidence-based care components for preventing ventilator-associated pneumonia.
Moving Toward Recovery
Conventional medical wisdom holds that physical activity is not an option for seriously ill patients tethered to life-saving equipment, and it is well-known that prolonged immobility causes severe and durable muscle weakness.
Applying Toyota Production System Principles in a Critical Care Unit
Virginia Mason Medical Center tested and adapted Toyota Production System principles in its Critical Care Unit, leading to more highly reliable and safer bedside care.
Evidence-Based Practices Reduce the Ventilator-Associated Pneumonia Rate for ICU Patients
Lancaster General Hospital reduced the ventilator-associated pneumonia rate for patients on mechanical ventilation in the ICU from 7.35 per 1,000 ventilator days in FY07 to 1.95 per 1,000 ventilator days in FY09.
Reducing Average Length of Stay on Mechanical Ventilation Using Bundles and Mobility
University of Rochester Medical Center targeted specific elements in the Ventilator and Central Line Bundles to increase compliance, thereby reducing ventilator-associated pneumonia, reducing CRBSIs, and decreasing average length of stay. In addition, a mobility initiative helped the team achieve daily sedation interruption and development of a new bundle further reduced CRBSIs.
Improving ICU Care: Reducing Complications from Ventilators and Central Lines
To improve safety and reduce complications in the ICU, Cape Coral Hospital focused on improving communication using multidisciplinary rounds and eliminating VAP and CL-BSI. The result was a significant decrease in these hospital-acquired infections as evidenced by 17 months without a VAP and 19 months without a CL-BSI.
Decreasing Harm to Patients by Standardizing Care
Northeast Health decreased harm to patients by standardizing care, including implementation of the Central Line and Ventilator Bundles and formation of a Rapid Response Team.
Reducing VAP for Long-Term Mechanical Ventilation Patients using the Ventilator Bundle
Coler-Goldwater Specialty Hospital and Nursing Facility reduced VAP from 2.4 to 1 VAP per 1,000 ventilator days among patients on long-term mechanical ventilators, primarily by implementing elements of the IHI Ventilator Bundle.
Saving Lives: Simple Interventions DO Really Help in the ICU
PeaceHealth/St. Joseph Hospital implemented the Ventilator and Central Line Bundles, resulting in 4+ months without a ventilator-associated pneumonia and 3+ months without a central line infection.
Leveraging IHI Participation to Achieve Critical Care Improvement Spread in a Multi-Hospital System
A system-wide Critical Care Collaborative was convened by Catholic Healthcare West (San Francisco, California, USA) modeled after the IHI Breakthrough Series Collaborative to achieve improvements in care systems in the intensive care setting resulting in reduction in ventilator-associated pneumonia rate, reduction in our catheter-related blood stream infection rate, improved compliance with all components of the ventilator bundle, reduction in ICU average length of stay, and reduction in percentage of patients in the ICU greater than 7 days.
Ventilator-Associated Pneumonia: Getting to Zero…and Staying There
Clinical evidence shows that by meticulously following a care protocol that includes keeping the patient's head elevated and discontinuing ventilator use as soon as possible, hospitals can virtually eliminate ventilator-associated pneumonia.
Reducing Length of Stay in Intensive Care
Conwy and Denbighshire NHS Trust have halved the average length of stay in the ICU and consequently increased patient throughput by 33.5 percent.
Reducing Hospital-Acquired Infections in a Long-Term Acute Care Hospital
Windy Hill Hospital (Marietta, Georgia, USA) has significantly reduced the number of hospital-acquired infections caused by MRSA, VRE, and C. difficile by implementing admission surveillance cultures and improving hand hygiene, among other improvements.
Creating and Implementing a Bundle to Reduce VAP in the NICU
Central DuPage Hospital reduced VAP in the NICU from a rate of 13.02 in 2004 to a rate of 5.43 in 2005 by implementing a neonatal ventilator bundle, reducing accidental extubations and a reinforcing handwashing.
Reducing Complications from Ventilators and Central Lines at Swedish Medical Center
Swedish Medical Center's Adult ICU team has spread ventilator-associated pneumonia rate improvements made in their Medical ICU to include a total of six ICUs.
Zero VAP Rate in the ICU by Reducing Time on Sedation
Mercy Hospital (Buffalo, New York, USA) has sustained zero ventilator-associated pneumonias in the ICU by reliably implementing the IHI Ventilator Bundle, with a special focus on reducing the amount and duration of sedation for patients on ventilators in the ICU.
A Team Gives Mobility to Ventilated Patients
Patients in critical care are usually kept immobile and heavily sedated, but there’s growing evidence that mobility can help a patient's long-term recovery.
Understanding Bundles: An IHI Faculty Conversation
IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).