Sustained Reduction of Ventilator-Associated Pneumonia Through a Structured Interdisciplinary Quality Improvement...

Ventilator-associated pneumonia (VAP) is a source of morbidity and mortality among critical care patients, particularly in trauma and burn. In 2022, our hospital identified a high incidence of VAP. This prompted a comprehensive evaluation and implementation of targeted interventions to improve outcomes in ventilated patients. The objective of this study was to evaluate the impact of a multifaceted strategy for VAP prevention by assessing its effectiveness in reducing VAP incidence through consistent application of evidence-based interventions. This pre- and post-quality improvement study was conducted at a Midwest Level I trauma center from 2022 to 2025. Interventions included standardized documentation with validation by a designated trauma program member, consistent use of a respiratory care protocol for intubated patients, and emphasis on extubation or tracheostomy decision-making during daily multidisciplinary rounds. Nursing staff introduced structured care cards to monitor oral hygiene, prophylaxis, sedation breaks, and equipment assessments. Audits were conducted using a visual accountability board system to reinforce compliance and enable immediate corrective actions. A Ventilator-Associated Event Committee representing nursing, infection prevention, respiratory therapy, trauma, critical care medicine, and quality improvement met monthly to review data, refine interventions, and support ongoing staff education. The results showed adherence to evidence-based VAP prevention practices improved, with a sustained reduction in VAP incidence from 3.3% to 0.4% across reporting periods. Coordinated interdisciplinary collaboration efforts, guided by structured and data-driven strategies, resulted in significant reductions in VAP rates and improved the overall quality of care for mechanically ventilated patients.