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Related Experiment Video

Updated: Jan 22, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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ZAP-VAP: A Quality Improvement Initiative to Decrease Ventilator-Associated Pneumonia in the Neonatal Intensive Care

Breanna Jacobs Pepin1, Debra Lesslie, Wendy Berg

  • 1Neonatal Intensive Care Unit (Mss Pepin and Lesslie and Dr Pokora) and Infection Prevention and Control (Ms Berg), Children's Minnesota, St Paul; and Children's Minnesota Research Institute, Minneapolis (Dr Spaulding).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|June 28, 2019
PubMed
Summary
This summary is machine-generated.

The ZAP-VAP bundle significantly reduced ventilator-associated pneumonia (VAP) rates in neonatal intensive care units (NICUs). This quality improvement initiative improved patient outcomes for mechanically ventilated infants, particularly those born extremely preterm.

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Area of Science:

  • Neonatal intensive care
  • Infection control
  • Quality improvement

Background:

  • Ventilator-associated pneumonia (VAP) is a significant hospital-acquired infection in neonatal intensive care units (NICUs).
  • Extremely preterm infants are the most vulnerable population to VAP, impacting neonatal morbidity and mortality.

Purpose of the Study:

  • To develop and evaluate the effectiveness of the ZAP-VAP prevention bundle.
  • To reduce VAP rates in a neonatal intensive care unit.

Main Methods:

  • The ZAP-VAP bundle and audit tools were developed and documented.
  • A retrospective and prospective analysis of electronic medical records was conducted for infants with a gestational age less than 29 weeks.
  • VAP rates were calculated per 1000 ventilator days before and after intervention.

Main Results:

  • VAP rates decreased significantly from 8.5 to 2.5 postintervention (P= .0004).
  • Median mechanical ventilation days decreased for VAP cases (47 to 33 days).
  • Median length of stay decreased for VAP cases (136 to 100 days).

Conclusions:

  • The ZAP-VAP protocol was successfully implemented and readily accepted by the NICU team.
  • The ZAP-VAP bundle is an effective and straightforward protocol for improving VAP outcomes in mechanically ventilated infants.
  • This intervention serves as a model for practice changes in other units and hospitals.