In the U.S. healthcare system there are approximately 1.7 million Healthcare-Associated Infections (HAIs) per year and 99,000 patient deaths per year due to HAIs. (3)
Of those infections, Ventilator Associated Pneumonia (VAP) is the second most common preventable HAI in ICU patients, occurs in approximately 9-27% of mechanically ventilated patients, and is the reason 50% of antibiotics are given to ICU patients. VAP carries with it a mortality rate between 9-50%. Ventilated patients are at risk for pneumonia due to the presence of the endotracheal tube interfering with natural defense mechanisms, such as cough reflex, and the potential for aspiration. (1)
In addition to pneumonia, ventilated patients are at risk for several potential complications associated with mechanical ventilation. Due to definitions for surveillance differing from definitions used for clinical diagnosis, the CDC developed an algorithm for ventilator-associated events surveillance. The CDC surveillance definitions include ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), possible pneumonia, and probable pneumonia. Approximately 5%–10% of mechanically ventilated patients develop VAEs. (2)
A: VAEs increase patient duration of ventilation, total length of stay and ICU length of stay. They also increase the risk of death and antibiotic use and increase medical costs. (5)
A: According to the 2014 IDSA/SHEA Practice Recommendations, the prevention strategies with a high quality of evidence include:
A: IDSA/SHEA recommends monitoring and reporting patient outcomes and compliance to recommended prevention strategies.(2) Collecting compliance data and reporting it transparently is the cornerstone to improving! Once you are completing data collection regularly, the data should be presented and addressed at all levels of the organization.
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1) https://ccforum.biomedcentral.com/articles/10.1186/cc13775
2) http://www.jstor.org/stable/10.1086/677144
3) http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf
4) http://www.cdc.gov/nhsn/pdfs/pscmanual/10-vae_final.pdf
5) http://www.aacn.org/wd/elearning/docs/elearningpdf/vae-ppt-handout.pdf