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Sustained Reduction of Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator

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Area of Science:

  • Critical Care Medicine
  • Infection Prevention
  • Healthcare Quality Improvement

Background:

  • Effectiveness of ventilator bundle practice for reducing ventilator-associated pneumonia (VAP) is debated.
  • Need for enhanced strategies to improve bundle compliance and patient outcomes.

Purpose of the Study:

  • To implement a comprehensive program utilizing a real-time bundle compliance dashboard.
  • To improve adherence to the ventilator bundle and decrease ventilator-associated complications.

Main Methods:

  • A before-and-after quasi-experimental study was conducted in 6 adult intensive care units (ICUs).
  • A real-time computerized dashboard was developed to monitor and facilitate instant correction of bundle compliance.
  • Bundle compliance was assessed as the percentage of time all elements were concurrently in compliance for all patients.

Main Results:

  • The VAP rate decreased from 19.5 to 9.2 VAPs per 1,000 ventilator-days post-implementation (P<.001).
  • Bundle compliance significantly increased from 23% to 83% (P<.001).
  • A moderate negative correlation was observed between bundle compliance and monthly VAP rates (r=-0.32).

Conclusions:

  • A prevention program incorporating a real-time bundle adherence dashboard significantly reduced VAP rates.
  • Sustained decreases in VAP and increased bundle compliance were observed in adult ICU patients.