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CS348
Use of eICU for Compliance with Ventilator Associated Pneumonia Compliance Items
By: M. Mullen-Fortino, K. Worley, & Fd. Sites; Penn E-Lert
For further information, please contact: mr4tno@aol.com
Purpose: Reducing VAP requires an organized process that utilizes consistent application of evidence based practices. Through the health systems clinical effectiveness and quality improvement (CEQI) method, a 14 bed intensive care unit (ICU) identified an opportunity to enhance outcomes related to VAP.
Description: Education of the VAP bundle components as outlined by the Institute for Healthcare Improvement’s 100,000 Lives Campaign was presented to nursing and respiratory staff in an effort to reduce VAP. Bundle compliance and VAP rates for the first quarter were presented to staff. Education alone proved to be ineffective in the reduction of VAP or in bundle compliance. The revision of the VAP plan included collaboration with the eICUŽ. The eICUŽ is the health systems telemedicine program charged with proactively identifying issues and for support of bedside staff. Beginning in the second quarter the eICUŽ monitored compliance of head of bed elevation, peptic ulcer prophylaxis and deep vein ulcer prophylaxis. The use of transparent documentation, daily management reports and video surveillance provided by eICUŽ assisted the ICU with monitoring of VAP bundle item compliance. This information was reviewed during daily combined medical and nursing rounds to enable conformity with bundle items. Monthly and quarterly VAP rates were presented to ICU staff.
Evaluation and Outcomes: Through collaboration with the eICUŽ, there was shown to be an inverse relationship between bundle compliance and reduction in VAP. Achievement of reduced VAP has occurred over the last five quarters due in part to the collaborative efforts of the ICU and eICUŽ. Education, dissemination of evidence based data, and the CEQI process has led to substantial and sustained improvements in VAP rates.
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