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Ventilator Associated Pneumonia

Ventilator Associated Pneumonia (VAP) is defined as a pneumonia (lung infection) occurring in patients in an Intensive Care Unit who require external mechanical breathing support (a ventilator) intermittently or continuously, through a breathing tube for more than 48 hours. VAP can develop in patients for many reasons. Because they are relying on an external machine to breathe, their normal coughing, yawning, and deep breath reflexes are suppressed. Furthermore, they may have a depressed immune system, making them more vulnerable to infection.

ICU teams have many ways to try to assist patients with these normal breathing reflexes, but despite this, patients are still at risk for developing pneumonia. In keeping with best practices with Safer Healthcare Now, at the NHS we are using new protocols to prevent VAP, such as: elevating the head of the patient’s bed 30 degrees; a daily assessment to determine if the patient is ready to come off the ventilator; decreasing sedation where possible; and placing a feeding tube in the mouth instead of the nose, to decrease sinus infection and resulting mucus build-up.

VAP incidents diagnosed after day 2 of admission for adult patients greater than 18 years of age:

VAP Intensive Care Units

 

All hospitals with ICUs ARE required to report into the Critical Care Information System (CCIS), a centralized data collection system where hospitals report a variety of critical care information, must publicly report the VAP indicator data. These hospitals are considered “eligible” for VAP reporting.

These Ontario hospitals are posting their quarterly VAP rate and case count for those infections acquired in their facility, using the following formula:

total # of ICU cases of VAPafter 48 hours of mechanical ventilation
 
total # of ventilator days for ICU patients 18 years and older
x 1000