Results from a Quality Improvement Project to Decrease Infection-Related Ventilator Events in Trauma Patients at a...

Area of Science:

• Critical Care Medicine
• Infection Prevention
• Trauma Surgery

Background:

• Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality in intensive care units.
• Clinical protocols, known as VAP bundles, have been developed to mitigate VAP rates.
• Adult trauma patients are at high risk for VAP due to the severity of their injuries and prolonged mechanical ventilation.

Purpose of the Study:

• To decrease VAP rates in adult trauma patients through a quality improvement project.
• To evaluate the impact of implementing evidence-based VAP prevention strategies.
• To assess the sustainability of VAP reduction through ongoing education and policy development.

Main Methods:

• A quality improvement project was initiated in 2009, involving the establishment of a VAP prevention committee.
• Formal, evidence-based education on VAP prevention was provided to nursing and physician staff.
• Compliance with VAP bundle elements was monitored, starting with 65% in 2010 and increasing to over 90% within one year, eventually reaching 100%.

Main Results:

• The study included 2380 adult trauma patients admitted to a Level II trauma center ICU between 2009 and 2016.
• VAP rates decreased dramatically and were sustained, declining from 12% in 2009 to 0% in 2016.
• High compliance rates with VAP prevention bundles were achieved and maintained.

Conclusions:

• The implementation of evidence-based education and VAP prevention bundles resulted in a sustained, significant reduction in VAP rates among adult trauma patients.
• Establishing a culture of excellence through ongoing education and policy development is crucial for maintaining favorable outcomes in VAP prevention.
• Continuous monitoring and education are essential for sustaining VAP prevention successes in high-risk trauma populations.