Zapping VAP: How a Medical Intermediate Unit Achieved Two and a Half Years Without a Ventilator Acquired Pneumonia

Purpose:
In 2012 the VMC Medical Intermediate Unit celebrated 2 1/2 years VAP free, receiving a US Department of Health & Human Services Outstanding Achievment Award for Eliminating Healthcare Associated Infections. This presentation will detail how MIU created a unit culture committed to VAP prevention.

Significance:
VAP increases length of stay, patient mortality, and costs $40,000 per incidence. Before implementing this program, this unit had the second highest VAP incidence in the organization. Sharing how this unit achieved 0 VAP will help other organizations protect their patients from this HAI.

Strategy and Implementation:
Creating a unit culture committed to VAP prevention and engaging staff at all levels was key. Implementing peer-to-peer bundle education was step one. A Quality Nurse Liaison role, held by an experienced staff RN who also serves as charge RN, was created to connect leadership with direct care RNs. Team building activities such as simulation learning fostered cooperation between nursing assistants, RNs, respiratory therapists, and MDs. Nursing assistants engaged in infection prevention measures and developed creative campaigns such as "Wipe Your Paws." Bundle compliance was monitored on a daily and weekly basis, with opportunities for improvement identified. For instance, nurses were engaged to coach residents to order required prophylaxis. All team members were held accountable and were engaged in developing creative solutions. As months VAP free were achieved, celebrations rewarded staff for their efforts. VAP prevention became the unit's source of pride and rally cry.

Evaluation:
Before these innovations were implemented, this unit had the second highest VAP incidence in the organization. Since the innovations were implemented, the unit has achieved nearly 3 years VAP free and has been recognized nationally. Success was measured by bundle compliance and infection rates.

Implications for Practice:
Identifying and disseminating innovative models to prevent healthcare associated infections is critical for patient safety. The various innovations that MIU developed to achieve nearly 3 years VAP free can be shared with other organizations in an effort to decrease nationwide VAP incidence.