Helping patients breathe easier by
reducing VAP

July 5, 2012 2:53 pm Views: 199
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Ventilator-assisted pneumonia is the leading cause of death among hospital-acquired infections – and it is preventable.

What is more surprising to you?

Is it that ventilator-associated pneumonia (VAP) is the leading cause of death among hospital-acquired infections and substantially increases the likelihood of mortality among ventilated patients?

Could it be that there is an estimated 4,000 adult cases of VAP every year in Canada, resulting in approximately 230 deaths, 17,000 intensive care unit (ICU) days and $46 million in health care costs? That’s roughly $14,000 per VAP patient.

Or, is it that many of these poor outcomes are the result of system failures that are completely preventable?

Nosocomially acquired infections in the intensive care unit (ICU) are common and invasively mechanically ventilated patients are particularly susceptible to nosocomial infections including pneumonia. VAP is counted as occurring in patients requiring a device intermittently or continuously to assist respiration through a tracheostomy or endotracheal tube.  Furthermore, the device must have been in place within the 48-hour period before onset of infection and for at least two consecutive days.

The good news is that you can make a difference and the Safer Healthcare Now! VAP bundle can help.

Similar to the bundles for any of the Safer Healthcare Now! interventions, the VAP bundle (developed in partnership with the Canadian ICU Collaborative) is a series of evidenced based best practices that when implemented together, should result in reductions in the incidence of VAP. In fact, a recent ICU Collaborative improvement project revealed, on average, a 45 per cent reduction in VAP when using elements of the bundle. This rate increases when the bundle is applied as a whole instead of piecemeal.

In keeping with the latest evidence, Safer Healthcare Now! and the Canadian ICU Collaborative have recently released an updated version of the VAP bundle.

These revisions include the case for preventing VAP, a clarification of the definition of VAP, added elements for adult VAP patients and additional revisions to the entire bundle to reflect new evidence in hand hygiene, VTE prophylaxis and the promotion of patient mobility and autonomy.

These modifications reflect the latest elements of practice that demonstrate the greatest ability to decrease the incidence of VAP.

Teams from health care organizations across Canada have already used the VAP bundle to reduce the incidence of VAP among their ICU patients. We encourage you to do the same . . . preventing harm is worth the effort.

Visit www.saferhealthcarenow.ca to download or learn more about the VAP bundle or any of the other interventions offered free of charge by Safer Healthcare Now! on a wide range of common patient safety issues. You may also listen to a recording of a national call held June 26 with VAP teams to discuss the latest changes to the bundle and gain access to expert help to assist with the reduction of VAP in your organization.

Article By:

Hugh MacLeod

Hugh MacLeod is the CEO of the Canadian Patient Safety Institute.

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