2.50
Hdl Handle:
http://hdl.handle.net/10755/164263
Category:
Abstract
Type:
Presentation
Title:
VAP sleuths. What the Evidence Has Shown Us on the Path to Target ZERO
Author(s):
Conley, Jude; McCord, Jennifer
Author Details:
Jude Conley, Bethesda North Hospital, Cincinnati, Ohio, USA, email: nacnsorg@nacns.org; Jennifer McCord MSN, RN, PCCN, CCRN, CCNS
Abstract:
Purpose: The purpose of this clinical project was to decrease VAP rates, Increase quality of care for the patient, and increases awareness among the medical and nursing staff. Significance: The literature shows that Ventilator Associated Pneumonia (VAP) has an associated cost of up to $40,00 per case and a mortality rate of 20-40%. After initiating the standard vent bundle with oral care, head of bed elevation, hand hygiene, closed vent circuits, etc., we were not at the target of Zero. Chart reviews were done to see if there were commonalties among these patients. Design: VAP was not a perceived problem in out hospital. No tracking of rates and occurrences was happening, as the impact of VAP was more prominent in the literature, we moved this to the forefront of our quality initiatives. Methods: We educated staff, increased awareness through evidence based practice being brought to the bedside, and utilized the SAGE company's products and further educated staff about oral hygiene. A VAP task force was established with ICU staff, respiratory therapist, Clinical Nurse Specialist, Nurse Managers, and Infection Control Nurse to look at VAP rates and further improvements in quality. Education and direct observation of practice were done to discover disconnects. Charts of VAP cases were reviewed. It was discovered that the VAP cases had common themes. These themes were identified and addressed with nursing, respiratory therapy, and medical staff as appropriate. Some of these cases were not staff failures, but system failures. Findings: VAP rates has steadily decreased to below the NISS Statistics of 4.9/1000 vent day to 1.4/1000 vent days. We are staying vigilant to decrease this to zero. We have increase direct observation of practice and monitor 100% of suspected or confirmed VAP cases. Conclusions: Correlations were found through chart review. To continue improvement in VAP rates, we discussed these Correlations with the ICU committee and the Ear, Nose, and Throat Physicians. It was decided to concentrate on the patients that were receiving tracheotomies to utilize chlorhexidine Oral rinse in these patients. In the year following, there were no VAP seen in the tracheotomy population. We continue to target patient populations that do develop VAP. Implications for Practice: Correlations were found through chart review. To continue improvement in VAP rates, we discussed these Correlations with the ICU committee and the Ear, Nose, and Throat Physicians. It was decided to concentrate on the patients that were receiving tracheotomies to utilize chlorhexidine Oral rinse in these patients. In the year following, there were no VAP seen in the tracheotomy population. We continue to target patient populations that do develop VAP.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
Clinical Nurse Specialists: Leaders in Clinical Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Atlanta, Georgia, USA
Description:
Conference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgia
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.titleVAP sleuths. What the Evidence Has Shown Us on the Path to Target ZEROen_GB
dc.contributor.authorConley, Judeen_US
dc.contributor.authorMcCord, Jenniferen_US
dc.author.detailsJude Conley, Bethesda North Hospital, Cincinnati, Ohio, USA, email: nacnsorg@nacns.org; Jennifer McCord MSN, RN, PCCN, CCRN, CCNSen_US
dc.identifier.urihttp://hdl.handle.net/10755/164263-
dc.description.abstractPurpose: The purpose of this clinical project was to decrease VAP rates, Increase quality of care for the patient, and increases awareness among the medical and nursing staff. Significance: The literature shows that Ventilator Associated Pneumonia (VAP) has an associated cost of up to $40,00 per case and a mortality rate of 20-40%. After initiating the standard vent bundle with oral care, head of bed elevation, hand hygiene, closed vent circuits, etc., we were not at the target of Zero. Chart reviews were done to see if there were commonalties among these patients. Design: VAP was not a perceived problem in out hospital. No tracking of rates and occurrences was happening, as the impact of VAP was more prominent in the literature, we moved this to the forefront of our quality initiatives. Methods: We educated staff, increased awareness through evidence based practice being brought to the bedside, and utilized the SAGE company's products and further educated staff about oral hygiene. A VAP task force was established with ICU staff, respiratory therapist, Clinical Nurse Specialist, Nurse Managers, and Infection Control Nurse to look at VAP rates and further improvements in quality. Education and direct observation of practice were done to discover disconnects. Charts of VAP cases were reviewed. It was discovered that the VAP cases had common themes. These themes were identified and addressed with nursing, respiratory therapy, and medical staff as appropriate. Some of these cases were not staff failures, but system failures. Findings: VAP rates has steadily decreased to below the NISS Statistics of 4.9/1000 vent day to 1.4/1000 vent days. We are staying vigilant to decrease this to zero. We have increase direct observation of practice and monitor 100% of suspected or confirmed VAP cases. Conclusions: Correlations were found through chart review. To continue improvement in VAP rates, we discussed these Correlations with the ICU committee and the Ear, Nose, and Throat Physicians. It was decided to concentrate on the patients that were receiving tracheotomies to utilize chlorhexidine Oral rinse in these patients. In the year following, there were no VAP seen in the tracheotomy population. We continue to target patient populations that do develop VAP. Implications for Practice: Correlations were found through chart review. To continue improvement in VAP rates, we discussed these Correlations with the ICU committee and the Ear, Nose, and Throat Physicians. It was decided to concentrate on the patients that were receiving tracheotomies to utilize chlorhexidine Oral rinse in these patients. In the year following, there were no VAP seen in the tracheotomy population. We continue to target patient populations that do develop VAP.en_GB
dc.date.available2011-10-27T11:45:05Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:45:05Z-
dc.conference.date2008en_US
dc.conference.nameClinical Nurse Specialists: Leaders in Clinical Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationAtlanta, Georgia, USAen_US
dc.descriptionConference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgiaen_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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