Kerri E. Bayer, RN, BSN, CCRN, Gayle A. Sturgis, RN, BSN, MBA, CC, and Lisa Rother. Nursing Education and Research, INTEGRIS Baptist Medical Center, 3400 NW Expressway, Suite 602, Oklahoma City, OK 73151
Objective: 1. The participant will be able to define ventilator associated pneumonia(VAP). 2. Participant will be able to discuss multiple interventions that the bedside caregiver can perform to reduce VAP Purpose: A multidisciplinary approach to decrease (VAP), utilizing education and increasing awareness in the ICU setting. Description: Evidenced Based educational material will be presented to assist other institutions in reducing their VAP rates. Summary: A review of the literature was performed to identify best practice. A multidisciplinary team devised an education program titled Z.A.P. V.A.P.: Z – zero tolerance with q4h oral care, A – apply ventilator order set, P – patient positioning, V – vacation from sedation, A – assess need for normal saline lavage, and P – prevent contamination. A mandatory 25 question pre-test was administered to ICU nurses and respiratory therapists to obtain baseline knowledge. A thirty-minute unit based discussion providing information from the AACN Practice Alerts was developed. In addition vendors performed walking educational rounds re-educating the staff on current products used to assist with oral care. After the education was completed, the mandatory test was re-administered to determine change knowledge. Implications: The post-test revealed an increase in knowledge concerning prevention of VAP. In addition, hospital data demonstrated a reduction in VAP rates to zero. As a result of this initiative, not only were VAP rates decreased, but 50 new nurses have joined AACN and are preparing to take their CCRN exam. An increase in knowledge, does not necessarily generate a change in practice. We are continuing with our education and focusing on smaller parts of our Z.A.P. V.A.P interventions at a time. We are currently educating the staff on the importance of oral care and head of bed elevation. The AACN Oral Care and VAP Practice Alerts have been distributed to reinforce this importance. We will continue to educate and audit these interventions and will encourage the involvement of family in the monitoring of oral care, patient positioning, and contamination prevention.
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