https://padlet.com/mpel90/o3sunrev1gnpxpg1 Reducing ventilator-associated events en-us 2023-04-22 22:22:40 UTC 2023-04-27 14:58:48 UTC hello@padlet.com mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564384310 Sherburne LM, Poehler JL, Tietz JM (2022). Reducing ventilator-associated events: a quality improvement project. Critical Care Nurse 42(2), 63-70. ]]> 2023-04-22 22:44:53 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564384310 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564656897 Ventilator associated events (VAE) effect patient outcomes. The gap illustrated in the quality improvement project was of a midwest hospital VAE rates and quality of care. The goal was to decrease unexpected events. 

In 2018, the VAE rate for this hospital was 25.58 per 1000 ventilator days. The goal was to lower the amount to 18 events per 1000 days by September 30, 2019. Stress levels of nurses were also considered in the project.]]> 2023-04-23 14:56:57 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564656897 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657024 VAE rates at the hospital were consistently higher than national standards. The project was completed to ensure staff had education and access to current best practice.

Current strategies for decreasing VAE rates include: daily spontaneous awakening and breathing trials, fluid management, early mobility, low-tidal-volume ventilation, and minimizing sedation. Oral care with chlorhexidine, elevation of the head of the bed, and drainage of secretions are also included strategies.

Some contributing factors for the higher VAE rates were found to be: lack of documentation and reasons for changing ventilator settings, and multiple disciplines making changes to ventilator rates. Another contributing factor was nurses’ perceptions of how often ventilators were discussed in rounds.

]]> 2023-04-23 14:57:12 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657024 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657168 The QI projected used: define, measure, analyze, improve, and control framework.

A multidisciplinary team made up of ICU Nurses, ICU physicians, and respiratory therapists.  

In person education was initiated as well as emails and information at staff meetings.

"Care of the Intubated Patient Toolkit" was put into effect. This toolkit includes information on rapid sequence intubation, documentation, ventilator resources, sedation after intubation, and prevention of VAEs.]]> 2023-04-23 14:57:33 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657168 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657501 The ventilator-associated event incidence rate decreased. The goal rate of less than or equal to, 18 events per 1000 ventilator days was achieved for the year 2019. This data was evaluated by the infection preventionist on staff, using a calculator by the National Healthcare Safety Network. 

Mixed methods were used to gain insight on the QI project. Quantitative data as explained above, for the actual number of events. And qualitative data based on surveys on stress levels of staff both before and after new implementation on education and communication.]]> 2023-04-23 14:58:17 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657501 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657630 The hospital found the best way to have improved outcomes with VAEs was with improved multidisciplinary communication, mainly between nursing staff, respiratory therapy and ICU physicians. 

Staff members were evaluated by tests administered before  and after the intervention which showed that the education was effective: 51% before, 86% after.

In regard to discussing ventilator settings in rounds, postimplementation data showed 69% of morning rounds included discussion and in 34% of evening rounds. The results increased from 0% before implementation.]]> 2023-04-23 14:58:32 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657630 mpel90 https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657821 Plan: Lower Ventilator Associated events at their hospital.
Do: Analyzed documentation from medical records and surveyed staff.
Study: Communication was lacking between departments. As well as documentation was not adequate. Education was also not on par with required levels.
Act: Because of the research the hospital was able to lower VAEs and improve communication, education, and patient safety.

Other hospitals who would like to study their VAE rates and improve them can base their QI project on this one because information of VAE is fairly new.]]> 2023-04-23 14:58:58 UTC https://padlet.com/mpel90/o3sunrev1gnpxpg1/wish/2564657821