By Mercy's Madelynn Innes
Did you know that pneumonia is the second most common hospital-acquired infection? And, according to the National Institute of Health, among those pneumonia cases, 86 percent are associated with mechanical ventilation.
That may be true for some hospitals, but Mercy co-workers on 3E’s intensive care unit are determined to beat those odds and put a stop to ventilator-associated pneumonia cases – commonly known as VAPs. As a result of the steps they’re taking, the last VAP case among patients on this cardiovascular ICU occurred more than a year ago.
“In an ICU like this one where cardio, surgical and other critically ill patients are treated, that says a lot,” said Infection Control Specialist Mary Ann Higginbotham. “Some patients on this unit are on the vent long-term, so their chances of developing pneumonia are greater, but 3E is doing an amazing job.”
Indeed, ventilators are lifesaving for critically ill patients who require breathing assistance. But when the ventilator tube that pumps lifesaving air into vulnerable lungs becomes contaminated, it can act as a pathway for bacteria or secretions to enter the respiratory tract, paving the way to a deadly VAP.
On 3E, says Nurse Manager Susan Thomas, “We’re diligent to follow our ventilator bundle – those are evidence-based practice guidelines that protect our patients from VAP.”
For instance, every day the unit’s nursing staff meet in huddle with hospitalists, intensivists, as well as respiratory and physical therapists to discuss the needs of each patients on their unit who is on a ventilator.
“They have excellent teamwork,” added Mary Ann. “Each member of the team focuses on their responsibility to follow their tasks of the ventilator bundle.”
For those who are able, Susan added, “We get our patients up and moving twice a day.”
Even for those patients who can’t get out of bed, they take other measures to prevent VAP. “Patients on ventilators should also have the head of their bed raised between 30 and 45 degrees. We also check the patient’s ability to breathe on his or her own every day – all in an effort to get that patient off of the ventilator as soon as possible.
On 3E and all other Mercy ICUs, Mercy's SafeWatch telemedicine program has also been instrumental in supporting staff with a virtual care team. Using computers, in-room cameras, audio connections and high-speed data lines, intensivists and experienced ICU nurses can provide around-the-clock remote support to assure that each of our patients on a ventilator is cared for according to the measures outlined in the VAP bundle.
As 3E is leading the way in preventive measures, Mercy also has a hospital-wide VAP prevention team with each of our ICUs, Infection Prevention among other department representatives. “We review every VAP case and discuss what changes should be made,” Mary Ann said. “That’s an important part of prevention and improving our hospital’s protocol and patient outcomes.”