2.50
Hdl Handle:
http://hdl.handle.net/10755/157138
Category:
Abstract
Type:
Presentation
Title:
Rinsing Away Ventilator Days with a Peridex Protocol in an Abdominal Transplant ICU
Author(s):
McCaffery, Deanna; Grogan, Tracy; O'Bryan, Kathleen
Author Details:
Deanna McCaffery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA, email: mccafferydm@upmc.edu; Tracy Grogan; Kathleen O'Bryan
Abstract:
PURPOSE: The Abdominal Transplant ICU (TICU) is a 28-bed unit for pre and post operative kidney/pancreas, liver, and small bowel/multi-visceral transplant patients. This patient population often has a long recovery time that requires extended periods of mechanical ventilation. Ventilator-associated pneumonia (VAP) rates in the TICU were consistently above Center for Disease Control (CDC) guidelines. A multidisciplinary team was formed to address the current standard of care for mechanically ventilated patients in the TICU. Description: After reviewing current mouth care practice for mechanically ventilated patients in the TICU, a Peridex Protocol for mouth care was initiated as standard of care for all mechanically ventilated patients to decrease VAP rates, improve patient outcomes and decrease length of stay. A plan of care was developed to ensure that mouth care was done consistently and correctly by all nursing staff using chlorhexidine gluconate (Peridex) instead of standard alcohol based mouthwash. Documentation for using Peridex was done as medication documentation, bite block was removed q 12hrs and documented against. In-services were provided to the medical, nursing and respiratory staff outlining the mouth care procedure, the mouth care documentation and the evidence based literature concerning VAP and Peridex oral rinse. Daily audits were performed on all mechanically ventilated patients ensuring proper procedure and documentation. Monthly TICU VAP rates were trended. EVALUATION: The outcome of the Peridex Protocol was that VAP rates dropped from above the 50th percentile (based on NNIS Percentile Ranking) to remaining consistently below the 50th percentile rate. VAP rates have been as low as 1.6 per 1000 ventilator days. The highest monthly rate in the year preceding the initiative was 16.9. Monthly VAP rates continue to be trended and staff education is done twice yearly. The average monthly compliance with mechanically ventilated patients being started on the protocol, correct documentation and implementation is between 92 and 96%. Peridex has also been added to the pre-printed order set for liver and small bowel transplant patients. Peridex is now used throughout our hospital system as a standard of care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleRinsing Away Ventilator Days with a Peridex Protocol in an Abdominal Transplant ICUen_GB
dc.contributor.authorMcCaffery, Deannaen_GB
dc.contributor.authorGrogan, Tracyen_GB
dc.contributor.authorO'Bryan, Kathleenen_GB
dc.author.detailsDeanna McCaffery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA, email: mccafferydm@upmc.edu; Tracy Grogan; Kathleen O'Bryanen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157138-
dc.description.abstractPURPOSE: The Abdominal Transplant ICU (TICU) is a 28-bed unit for pre and post operative kidney/pancreas, liver, and small bowel/multi-visceral transplant patients. This patient population often has a long recovery time that requires extended periods of mechanical ventilation. Ventilator-associated pneumonia (VAP) rates in the TICU were consistently above Center for Disease Control (CDC) guidelines. A multidisciplinary team was formed to address the current standard of care for mechanically ventilated patients in the TICU. Description: After reviewing current mouth care practice for mechanically ventilated patients in the TICU, a Peridex Protocol for mouth care was initiated as standard of care for all mechanically ventilated patients to decrease VAP rates, improve patient outcomes and decrease length of stay. A plan of care was developed to ensure that mouth care was done consistently and correctly by all nursing staff using chlorhexidine gluconate (Peridex) instead of standard alcohol based mouthwash. Documentation for using Peridex was done as medication documentation, bite block was removed q 12hrs and documented against. In-services were provided to the medical, nursing and respiratory staff outlining the mouth care procedure, the mouth care documentation and the evidence based literature concerning VAP and Peridex oral rinse. Daily audits were performed on all mechanically ventilated patients ensuring proper procedure and documentation. Monthly TICU VAP rates were trended. EVALUATION: The outcome of the Peridex Protocol was that VAP rates dropped from above the 50th percentile (based on NNIS Percentile Ranking) to remaining consistently below the 50th percentile rate. VAP rates have been as low as 1.6 per 1000 ventilator days. The highest monthly rate in the year preceding the initiative was 16.9. Monthly VAP rates continue to be trended and staff education is done twice yearly. The average monthly compliance with mechanically ventilated patients being started on the protocol, correct documentation and implementation is between 92 and 96%. Peridex has also been added to the pre-printed order set for liver and small bowel transplant patients. Peridex is now used throughout our hospital system as a standard of care.en_GB
dc.date.available2011-10-26T19:27:21Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:27:21Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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