The existence of ventilator-associated pneumonia, or VAP, has long been a topic of controversial discussion. Diagnosing VAP is difficult because the radiologic and clinical signs can be associated with a variety of respiratory infections as well as other common physiologic responses to being on ventilator. Even so, VAP is the most frequent life-threatening nosocomial infection in intensive care units1. The infection targets those with compromised immunities such as elderly or surgical patients.
Ventilator-associated pneumonia occurs when microorganisms invade the lower respiratory tract of patients on a ventilator. Patients who contract VAP have an attributed mortality rate of 10% although this varies by patient2.Ventilator-associated events (VAEs) are no small issue for healthcare organizations. VAP increases length of hospital stay and subsequently increases healthcare costs. Studies have shown that on average, a ventilator-associated pneumonia case increases healthcare costs by $40,0003. For years hospitals have struggled to diagnose and treat VAP, but more importantly, they have been looking for cost effective interventions that can prevent ventilator-associated events from happening in the first place.
The Centers for Disease Control and Prevention (CDC) lists optimized hand hygiene as an appropriate procedure for preventing ventilator-associated events4,5. Improper hand hygiene is widely accepted as the main cause of all hospital acquired infections (HAIs), yet so many facilities still struggle with hand hygiene compliance rates. Many facilities report inaccurate numbers for their hand hygiene performance data as a result of the flaws in direct observation (more on that here). Everyone wants to improve hand hygiene in an effort to reduce the likelihood of ventilator-associated events, but with inaccurate data, that can be an impossible task.
Six hospitals decided to try something different. They each installed our hand hygiene reminder system in various units in an effort to better track hand hygiene and decrease ventilator-associated events, like pneumonia. VAE rates from at least 8 months prior to the installation of the system were compared to VAE rates 8 months after the installation of the system.
All six facilities saw a significant drop in ventilator-associated events after the installation of our hand hygiene reminder system. VAEs were reduced on average by over 84%, indicating that improving hand hygiene is an effective approach to combatting all VAEs, including VAP.