Eliminating Ventilator-associated Pneumonia From Hospitals

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Respiratory / Asthma;  MRSA / Drug Resistance
Article Date: 22 Feb 2006 - 8:00 PDT

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The Institute for Healthcare Improvement (IHI) announced today that 14 hospitals enrolled in its 100,000 Lives Campaign have had no cases of ventilator-associated pneumonia for one year or more.

Ventilator-associated pneumonia (VAP) is a lung infection that can develop in patients dependent on mechanical ventilators to help them breathe. It typically occurs in intensive care units. Fifteen percent of patients on ventilators develop this serious complication. VAP is a leading killer among all hospital-acquired infections, causing an estimated 26,000 deaths every year.

Launched in December 2004, the 100,000 Lives Campaign is the first-ever national initiative that aims to save a large and specified number of lives by a certain date (June 2006). The Campaign asks participating hospitals to implement six evidence-based interventions, one of which targets VAPs. A series of steps, such as raising the head of the bed to an angle of 30-45 degrees and making sure to wean patients off the ventilators as quickly as possible, can cut the deadly infection rate dramatically and, in the case of these pioneering hospitals, to zero.

The following hospitals report that they have eliminated VAPs for one year or more, either throughout the hospital or in specific intensive care units:

-- Baptist Memorial DeSoto - Southhaven, MS
-- Baptist Memorial Hospital Golden Triangle - Columbus, MS
-- Bay Regional Medical Center - Bay City, MI
-- Columbus Regional Hospital - Columbus, IN
-- Dominican Hospital - Santa Cruz, CA
-- McLeod Regional Medical Center - Florence, SC
-- OSF Saint Francis Medical Center - Peoria, IL
-- Overlake Hospital Medical Center - Bellevue, WA
-- Palmetto Health Baptist - Columbia, SC
-- Ridgeview Medical Center - Waconia, MN
-- Sentara Norfolk General Hospital - Norfolk, VA
-- Sentara Williamsburg Community Hospital - Williamsburg, VA
-- University of Rochester Medical Center/Strong Memorial Hospital - Rochester, NY
-- Upper Chesapeake Medical Center - Bel Air, MD

In addition, the following hospitals have made extraordinary progress in reducing VAPs, either throughout the hospital or in specific intensive care units:

-- Anaheim Memorial Medical Center - Anaheim, CA - no cases in 6 months;
-- Atlantic General Hospital/Health System - Berlin, MD - no cases in 7 months and only one case in 13 months;
-- BryanLGH Medical Center - Lincoln, NE - no cases in 11 months;
-- Hilo Medical Center - Hilo, HI - only one case in 12 months;
-- Our Lady of Lourdes Medical Center - Binghamton, NY - only one case in
-- 15 months;
-- Swedish Medical Center - Seattle, WA - no cases in 5 months.

"These results are truly remarkable - testifying to the hospitals' deep commitment to dramatically improve the quality of the health care they provide. These organizations have shown that ventilator-associated pneumonia, which occurs all too frequently in U.S. hospitals, is by no means inevitable," said IHI president and CEO Donald M. Berwick, MD, MPP. "The challenge now is to make these improvements permanent and to make this the new standard of care across the country."

Hospitals participating in the 100,000 Lives Campaign commit to implementing some or all of the following six quality improvement changes:


-- Activate a Rapid Response Team at the first sign that a patient's condition is worsening and may lead to a more serious medical emergency.

-- Prevent patients from dying of heart attacks by delivering evidence-based care, such as appropriate administration of aspirin and beta-blockers to prevent further heart muscle damage.

-- Prevent medication errors by ensuring that accurate and continually updated lists of patients' medications are reviewed and reconciled during their hospital stay, particularly at transition points.

-- Prevent patients who are receiving medicines and fluids through central lines from developing infections by following five steps, including proper hand washing and cleaning the patient's skin with "chlorhexidine" (a type of antiseptic).

-- Prevent patients undergoing surgery from developing infections by following a series of steps, including the timely administration of antibiotics.

-- Prevent patients on ventilators from developing pneumonia by following four steps, including raising the head of the patient's bed between 30 and 45 degrees.

The 100,000 Lives Campaign is supported through unrestricted philanthropy from The Robert Wood Johnson Foundation, Blue Cross Blue Shield of Massachusetts, the Cardinal Health Foundation, the Colorado Trust, Gordon and Betty Moore Foundation, the Rx Foundation, Baxter International, the Blue Shield of California Foundation, and the Leeds Family Foundation. Please visit http://www.ihi.org/campaign to learn more about the Campaign.

The Institute for Healthcare Improvement (www.ihi.org) is a not-for-profit organization leading the improvement of health care throughout the world. Founded in 1991 and based in Cambridge, MA, IHI is a catalyst for change, cultivating innovative concepts for improving patient care and implementing programs for putting those ideas into action. Thousands of health care providers, including many of the finest hospitals in the world, participate in IHI's groundbreaking work.

http://www.ihi.org

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