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Improving Ventilator Care Quality Through a Structured Ventilator Pathway: A Retrospective Pre-Post Quality
Darshana Rathod1, Kankana Samanta1, Piyali Chaudhari2
1Department of Critical Care Medicine, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, IND.
Cureus
|June 9, 2026
Summary
Implementing a ventilator pathway significantly reduced ventilator-associated events (VAE) and infections in critically ill patients. This quality improvement initiative enhanced patient outcomes and care standardization.
Area of Science:
- Critical Care Medicine
- Infectious Disease Prevention
- Healthcare Quality Improvement
Background:
- Mechanical ventilation (MV) is vital but carries risks like VAE, complications, and mortality.
- Existing VAP bundles have limitations in sensitivity and specificity.
- VAE surveillance (VAC, IVAC, PVAP) offers a standardized approach to monitoring complications.
Purpose of the Study:
- To assess VAE incidence at a tertiary care center.
- To evaluate the impact of a ventilator pathway on patient outcomes and VAE rates.
- To identify deficiencies in current ventilator care practices.
Main Methods:
- Retrospective study of patients on MV for >48 hours.
- Pre-implementation survey and VAP bundle audit to identify care gaps.
- Development and implementation of an evidence-based ventilator pathway with staff training.
Main Results:
- VAE incidence decreased by 87% post-implementation (28.46% to 3.71%).
- Significant reductions observed in VAC, IVAC, and PVAP rates.
- Hospital length of stay decreased (19 to 16 days), and total infection rates dropped significantly (12.40% to 1.62%).
Conclusions:
- A structured ventilator pathway improves infection control and standardizes care.
- This initiative led to reduced VAE incidence and infection rates.
- Clinical pathways are effective tools for sustainable quality improvement in critical care.
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