Ventilator Associated Pneumonia as a Nurse Sensitive Outcome: The Role of the Clinical Nurse Specialist in the Development and Implementation of Clinical Systems to Reduce Ventilator Associated Pneumonia

2.50
Hdl Handle:
http://hdl.handle.net/10755/164151
Category:
Abstract
Type:
Presentation
Title:
Ventilator Associated Pneumonia as a Nurse Sensitive Outcome: The Role of the Clinical Nurse Specialist in the Development and Implementation of Clinical Systems to Reduce Ventilator Associated Pneumonia
Author(s):
Murray, Theresa
Author Details:
Theresa Murray, RN, MSN, CCRN, Community Health Network, Indianapolis, Indiana, USA, email: nacnsorg@nacns.org
Abstract:
Problem and Significance: The Centers for Disease Control defines ventilator associated pneumonia (VAP) as pneumonia in patients who have been on mechanical ventilation for more than 48 hours. VAP falls under the umbrella of hospital-acquired pneumonia, and accounts for ten to fifteen percent of all nosocomial infections. VAP is the most common of the infections seen in the intensive care unit and is associated with the highest mortality rate. Purpose: This project was designed to implement evidenced based interventions aimed at preventing ventilator-associated pneumonia, including the system level changes that support implementation of the selected interventions. Description of Project: This project involved creating goal directed, multi-focused, evidence based interventions for reducing/eliminating VAP in an integrated health network with several ICUs. Methods: The implementation of many evidenced based and overlapping systems, called independent redundancies, was used. The concept of independent redundancies involves putting multiple triggers in the system to help assure that a particular activity will take place with high reliability. Some examples of these interventions are protocols for mobility, enteral nutrition, weaning the ventilator and pain and anxiety management; education of all caregivers on key principles of VAP prevention; changes in the equipment used and the process for caring for this equipment and the patient receiving mechanical ventilation. Multiple environmental reminders were used to assure that each patient, each day, receives interventions to prevent VAP. Outcomes: Within several months, each ICU was at an internal benchmark of 'green light' status on each of the identified process measures targeted at the preventing VAP. Green light status is attained when ninety five percent of the time each patient has every intervention. Each ICU now has gone over 60 days without a VAP, the longest has been 314 days, and one unit currently has had no VAP for the entire year of 2004. Conclusions and Nursing Implications: Systematic implementation of independent redundancies in a clinical arena can assure significant clinical performance improvement. These system improvements have added evidence to the notion that VAP is a nurse sensitive outcome and can be prevented in most patients. By implementing the interventions using a multiple redundancies strategy, a clinical nurse specialist can help reduce or eliminate VAP in a critical care unit, significantly improving the quality of care in the critical care unit, and potentially reducing cost and mortality.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
CNS Leadership: Navigating the Healthcare Environment Toward Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Orlando, Florida, USA
Description:
Conference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, 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_US
dc.typePresentationen_GB
dc.titleVentilator Associated Pneumonia as a Nurse Sensitive Outcome: The Role of the Clinical Nurse Specialist in the Development and Implementation of Clinical Systems to Reduce Ventilator Associated Pneumoniaen_GB
dc.contributor.authorMurray, Theresaen_US
dc.author.detailsTheresa Murray, RN, MSN, CCRN, Community Health Network, Indianapolis, Indiana, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164151-
dc.description.abstractProblem and Significance: The Centers for Disease Control defines ventilator associated pneumonia (VAP) as pneumonia in patients who have been on mechanical ventilation for more than 48 hours. VAP falls under the umbrella of hospital-acquired pneumonia, and accounts for ten to fifteen percent of all nosocomial infections. VAP is the most common of the infections seen in the intensive care unit and is associated with the highest mortality rate. Purpose: This project was designed to implement evidenced based interventions aimed at preventing ventilator-associated pneumonia, including the system level changes that support implementation of the selected interventions. Description of Project: This project involved creating goal directed, multi-focused, evidence based interventions for reducing/eliminating VAP in an integrated health network with several ICUs. Methods: The implementation of many evidenced based and overlapping systems, called independent redundancies, was used. The concept of independent redundancies involves putting multiple triggers in the system to help assure that a particular activity will take place with high reliability. Some examples of these interventions are protocols for mobility, enteral nutrition, weaning the ventilator and pain and anxiety management; education of all caregivers on key principles of VAP prevention; changes in the equipment used and the process for caring for this equipment and the patient receiving mechanical ventilation. Multiple environmental reminders were used to assure that each patient, each day, receives interventions to prevent VAP. Outcomes: Within several months, each ICU was at an internal benchmark of 'green light' status on each of the identified process measures targeted at the preventing VAP. Green light status is attained when ninety five percent of the time each patient has every intervention. Each ICU now has gone over 60 days without a VAP, the longest has been 314 days, and one unit currently has had no VAP for the entire year of 2004. Conclusions and Nursing Implications: Systematic implementation of independent redundancies in a clinical arena can assure significant clinical performance improvement. These system improvements have added evidence to the notion that VAP is a nurse sensitive outcome and can be prevented in most patients. By implementing the interventions using a multiple redundancies strategy, a clinical nurse specialist can help reduce or eliminate VAP in a critical care unit, significantly improving the quality of care in the critical care unit, and potentially reducing cost and mortality.en_GB
dc.date.available2011-10-27T11:42:59Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:42:59Z-
dc.conference.date2005en_US
dc.conference.nameCNS Leadership: Navigating the Healthcare Environment Toward Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.descriptionConference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, USAen_US
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.en_US
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