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Ventilator Associated Pneumonia

Ventilator Associated Pneumonia Care

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Ventilator Associated Pneumonia Care Management at Mayo Clinic

One way to evaluate the care of hospital patients requiring mechanical ventilators is to look at the percentage of eligible (appropriate) patients whose care met the care guidelines listed in above chart — the number of people who received the 4 components of the ventilator bundle. The goal for all medical facilities is to meet this guideline in 100 percent of eligible patients.

This graph shows the percentage of Mayo Clinic hospital patients receiving the four components of the ventilator bundle at all Mayo sites. As you can see, Mayo Clinic administered every element of the ventilator bundle in 97 to 100 percent of patients on ventilators at the various sites, during the second quarter of 2007.

How Ventilator Associated Pneumonia is Measured and Evaluated

The quality measures listed in the table below are known as the "standards of care" for managing hospitalized patients who require ventilators to help them breathe. This list includes the medical care widely accepted as the most appropriate care guidelines for the majority of patients who require a ventilator.

Standards of Care for Ventilator Associated Pneumonia

Standards of care for ventilator associated pneumonia

An explanation of this care

Number of patients using mechanical ventilator who receive all four components of the ventilator bundle. These include:

  1. elevation of the head of the bed to between 30 and 45 degrees
  2. daily "sedation vacation" and daily assessment of readiness to remove the ventilator
  3. peptic ulcer disease prophylaxis
  4. prophylaxis for deep vein thrombosis

Measures 1 and 2 are designed to help prevent VAP. "Sedation vacation" refers to a temporary halt in the use of sedatives to test whether the patient may be ready to stop using the mechanical ventilator.

Measures 3 and 4 are designed to help prevent other complications associated with mechanical ventilation.

Other Factors to Consider

An improvement project was undertaken at Mayo Clinic sites in early 2007 to examine and implement strategies for decreasing VAP. A key outcome of this effort was the implementation of defined care procedures for patients requiring a ventilator. These procedures were based on recommendations from existing research on what elements of care are most effective in preventing pneumonia in patients requiring a ventilator. A follow up initiative currently underway is focusing on improving the early diagnosis of patients with suspected VAP, standardization of the treatment for confirmed VAP with the appropriate use of antibiotics, and guidance for antibiotic management.

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