Practice Plan

Establish and consistently implement VAP prevention guidelines that focus on surveillance, minimization of ventilator  patient  days,  prevention  of  aspiration  and  gastric  distention,  equipment  cleansing,  oral  hygiene  and avoidance of unintended extubation and reintubation \cite{18840087}. An example of an evidence-based bundle is the Institute for Healthcare  Improvement’s  How-to  Guide:  Prevent  Ventilator  Associated  Pneumonia.  This  Guide  can  be  accessed online through the Institute for Healthcare Improvement (IHI)\cite{00007}. In addition the Armstrong Institute for Patient Safety and Quality at John Hopkins University has published a Toolkit to Improve Safety of Mechanically Ventilated Patients that includes recommendations on preventing, measuring and tracking outcomes related to VAP. This Toolkit can be accessed online through the John Hopkins Medicine website \cite{institute}
We have also listed the key components here:

Technology Plan

Suggested practices and technologies are limited to those proven to show benefit or are the only known technologies with  a  particular  capability.  As  other  options  may  exist,  please  send information  on  any  additional  technologies, along with appropriate evidence, to info@patientsafetymovement.org

Metrics

Topic:

Ventilator-associated Pneumonia Rate (VAP)
Rate of patients on a ventilator for more than 48 hours who develop pneumonia while on the ventilator or within 1day of ventilator removal per 1,000 ventilator-days

Outcome Measure Formula:

Numerator: Ventilator-associated Pneumonia infections based on CDC NHSN definitions for all inpatient units \cite{00009}
Denominator: Total number of ventilator-days for all patients on a ventilator in all tracked units
* Rate is typically displayed as VAP/1000 ventilator days

Metric Recommendations:

Indirect Impact:

All patients with conditions that lead to temporary or permanent ventilation

Direct Impact:

All patients that require invasive ventilation