Ventilator-Associated Pneumonia (VAP)

Patients with breathing problems may need a mechanical ventilator (breathing machine) to support them for a while. The lungs receive oxygen through a breathing tube connected to the ventilator. The breathing tube can make it easier for pneumonia to occur and sometimes stomach acid contents can get into lungs. VAP occurs in up to 15% of patients receiving mechanical ventilation, with a mortality of up to 50%. By adhering to safe practices, we have been able to significantly reduce our ventilator associated pneumonia.

Ventilator-Associated Pneumonia Reduction

What does this mean?

This means that our adherence to safe practices has been effective. In four years we have achieved an eight-fold reduction in ventilator associated pneumonia. Published benchmarks for medical and surgical patients include a mean rate according to size and teaching status as outlined below. Caritas has both teaching and non teaching programs.

Hospital type	ICU bed count	Mean rate per 1000 ventilator days
Nonteaching	>15	1.9
Teaching		2.9
Nonteaching	<15	2.2

(Am J Infection Control 2009;37;783-805).

In 2009 there were only two ventilator associated pneumonias among our six hospitals. Our aim however, is to never have a ventilator-associated pneumonia.

What are we doing to improve?

We want to eliminate all ventilator associated pneumonia. Through our regular system collaborative meetings, we share best practices from each hospital. We will continue to promote adherence to safe practices, including: keeping the head of the bed elevated between 30 and 45 degrees, neutralizing stomach acid with medication, keeping a pressure cuff inflated on the breathing tube to block stomach contents, reducing mouth bacteria with oral care and reviewing daily the need for the breathing tube and removing it as soon as is safe.