evelyn mello, bsmt, (ascp) ms, cic infection control practitioner
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Evelyn Mello, BSMT, (ASCP) MS, CICInfection Control Practitioner
Ventilator-Associated PneumoniaMetroWest Medical Center’s Journey
MWMC is a 2-hospital system Framingham Union Hospital in Framingham Leonard Morse Hospital in Natick
269 bed community teaching hospital 2 critical care units, total of 21 beds 24/7 Intensivist / Pulmonologist ICU / CCU coverage 4 days average length of stay on ventilator
Ventilator-Associated Pneumonia Project
BackgroundStarted in 2005 – IHI 100K Lives CampaignReview of our VAP rates –
In 2004 – 4 VAP cases, 2.8/1000 vent. days
VAP Bundle and education / Implementation Aim
Reduce VAP at MWMC to 0% within 1 year
Ventilator-Associated Pneumonia Project
Multidisciplinary Team Approach ICU/CCU Staff, Respiratory Therapy, Intensivists, Infectious Disease
MDs, Infection Control Practitioners, Pharmacy, Quality
Developed VAP Bundle Checklist and signage Additional Interventions
Increased use of non-invasive ventilation – CPAP Chlorhexidine Mouthwash Spontaneous breathing trial done on all vent. patients daily Fast-track all vent. patients – wean and extubate quickly Resp. staff monitoring of VAP bundle with vent. checks (q 2 hours)
Lessons Learned Teamwork leads to Positive Patient Outcomes & Quality Patient Care
MetroWest Medical Center Ventilator Associated Pneumonia
4
1
2 2
0 0
2.80
0.40
1.001.20
0.00 0.00
0
1
2
3
4
5
2004 2005 2006 2007 2008 2009 Quarter 1
# VAP Cases
VAP Rate per 1,000 vent days
2004 - Baseline 2005 - VAP Bundle Implemented (Education)
2006 - 2007Maintained 50% decrease from
baseline
2008 - Q1 2009 100% decrease from
baseline
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