VAP Getting Started Kit - Safer Healthcare Now!

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Safer Healthcare Now! 3.0 Paediatric VAP Bundle Compliance – Worksheet June 2012 Prevent Ventilator Associated Pneumonia Getting Started Kit 50
Safer Healthcare Now! Prevent Ventilator Associated Pneumonia Getting Started Kit 2.0 ADULT VAP Bundle Compliance 3.0 PAEDIATRIC VAP Bundle Compliance – Technical Description Intervention(s): Prevention of Ventilator-Associated Pneumonia Definition: The percentage of intensive care patients on mechanical ventilation for whom all elements of the VAP bundle are implemented unless contraindicated and documented on the daily goals sheet and/or elsewhere in the medical record through regular audit processes. Goal: 95% of all patients on mechanical ventilation in the intensive care unit(s) receive all five elements of the VAP bundle. Historically, this level of reliability has been achieved by building an infrastructure using multidisciplinary rounds and daily goals. CALCULATION DETAILS: Numerator Definition: Number of intensive care unit patients on mechanical ventilation at time of audit for which all elements of the VAP bundle are documented and in place. The five ADULT VAP bundle elements, unless contra-indicated, are: 1. Elevation of the head of the bed to 45° when possible, otherwise attempt to maintain the head of the bed greater than 30° should be considered 2. Daily evaluation of readiness for extubation. 3. The utilization of endotracheal tubes with subglottic secretion drainage. 4. Oral care and decontamination with Chlorhexidine. 5. Initiation of safe enteral nutrition within 24-48h of ICU admission. The five Pediatric VAP bundle elements, unless contra-indicated, are: 1. Elevation of the Head of Bed (HOB) in infants and children 2. Proper positioning of oral or nasal gastric tube in infant and children 3. Oral Care in pediatric patients 4. Eliminate the routine use of instil for suctioning for paediatric patients 5. Keep the ventilator tubing in a dependant position NOTE: This is an “all or nothing” indicator. If any of the elements are not documented or visualized at the time of audit, do not count the patient in the numerator. If a bundle element is contraindicated for a particular patient and this is documented appropriately in the medical record, then the bundle can still be considered compliant with regard to that element. Numerator Exclusions: • Exclude patients receiving non invasive ventilation • For adult population: Exclude patients less than 18 years of age at the date of ICU admission • For pediatric population: Exclude patients 18 years old and more June 2012 51
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VAP Getting Started Kit - Safer Healthcare Now!

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