What is ventilator-associated pneumonia (VAP)?
A ventilator is a piece of medical equipment that helps a patient who cannot breathe on his or her own by delivering oxygen directly to the patient's lungs. That is done through a tube placed in patient's mouth, nose or a hole in the front of the neck created through a surgical procedure. Ventilators can save lives by helping patients breathe until they can breathe without assistance, however, ventilators also carry a risk of pneumonia because they make it easier for germs to travel into a patient's lungs. Pneumonia is an infection of the lungs, and it is a serious medical condition that can make it hard for a patient to breathe and deliver needed oxygen to organs throughout the body.
What are we doing to reduce VAP infections?
To prevent ventilator-associated pneumonia, doctors, nurses, respiratory therapists and other health care team members:
- Properly position the patient in his or her bed by raising the head of the bed to an angle beween 30 and 45 degrees. Medical evidence shows this reduces the risk of infection. Sometimes this step is not taken if the patient's other medical conditions don't allow the bed to be adjusted.
- Take the patient off of the ventilator as soon as possible. They check every day whether the patient can breathe on his or her own.
- Clean their hands with soap and water or an alcohol-based hand cleanser before and after touching the patient or the ventilator.
- Avoid opening the airway tube between the ventilator and patient unless absolutely necessary -- helping to prevent germs from entering a patient's body.
- Perform oral hygiene for the patient by cleaning his or her mouth regularly. This reduces the number of naturally occurring bacteria in a person's mouth, also reducing the risk of lung infection by those germs.
- Clean and replace ventilator equipment regularly.
What can patients do to help?
Patients and their family members can also help reduce the risk of ventilator-associated pneumonia. To learn what you can do to help, please read the VAP fact sheet.
How are we doing?
We have developed a number of programs to help increase our compliance with the safest practices noted above. One example is our efforts to improve hand hygiene, which has led to a steady increase in successful hand-hygiene rates. The results of our efforts are lower VAP rates, from approximately three infections per 1,000 device days in 2003 to 1.5 infections per 1,000 days in 2010. Our infection rates are calculated by comparing the number of infections for every 1,000 days our patients are on ventilators. Our VAP rates are significantly lower than benchmarks set by the National Healthcare Safety Network, a group of more than 1,500 hospitals throughout the country. Those benchmarks compare our intensive care units to similar units at major teaching hospitals throughout the country.
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