Hospitals in pursuit of excellence

Zero Tolerance: The VAP Prevention Initiative

The Problem

Pneumonia accounts for 15 percent of all hospital-associated infections. It is the second most common hospital-associated infection after urinary tract infections. The primary risk factor for the development of hospital-associated bacterial pneumonia is mechanical ventilation. Fatality rates for hospital-associated pneumonia of 20 to 33 percent have been reported; in one study, VAP accounted for 60 percent of all deaths due to hospitalassociated infections, according to the Centers for Disease Control and Prevention.

The Solution

Baylor Regional Medical Center at Plano developed a proactive, multidisciplinary approach to eliminate VAP. This approach included using the ventilator bundle, a package of evidence-based interventions introduced by the Institute for Healthcare Improvement. The interventions call for:

• Elevation of the patient’s head between 30–45 degrees;
• Daily awakening of the patient, also called sedation vacation and daily assessment of the patient’s readiness for weaning from the ventilator;
• Peptic ulcer disease prophylaxis; and
• DVT (deep vein thrombosis) prophylaxis, unless contraindicated.

Read the results by clicking "view item."