Authors (including presenting author) :
Kan CY(1), Law WK(1), Lam KK(1), Ma TC(1)
Affiliation :
(1)Tuberculosis and Chest Medical Unit, Grantham Hospital
Introduction :
Ventilator associated pneumonia (VAP) is a challenge for health care sector. It causes extra burden to health care system due to prolonged mechanical ventilation (MV) days, extra length of stay (LOS) and problem of antimicrobial resistant organism. Bundle of care is reported to be effective for decreasing VAP incidence. For TBCU, we have a group of patients who required long term ventilator support and It is deemed necessary to standardize departmental practices for preventing VAP.
Objectives :
After reviewing literatures, guidelines from international authorities as well as local authorities (Center of Health Protection and Hospital Authority), a tailor-made VAP bundle for GH TBCU Chronic Ventilator Ward was formulated.
Methodology :
VAP bundle for Chronic Ventilator Ward was formulated in form of a checklist. Educational sessions and posters were prepared for consolidation of the concept and reinforcement of the bundle of care. The bundle of care was launched by using the specially designed checklist, incorporation of automated cuff pressure controller as well as modification of ward apparatus.
Result & Outcome :
VAP rate dropped from 14.98 / 1000 ventilator days to 4.72 /1000 ventilator days after implementation of the bundle of care. The compliance of individual measures ranging from 71.6% to 100%. The measure with lowest compliance is mobilizaton, limited by factors such as deterioration of patient, refusal by patient. Mean score of the knowledge assessment test on VAP bundle increased from 71.4% to 93.82% after education sessions. VAP rate of the unit was computed before and after the launch of the bundle in order to examine the effectiveness of tailor-made VAP bundle. Staff compliance on the tailor-made VAP bundle was measured for internal audit. Pre-test and post-test were designed to assess the knowledge level of nursing staff on VAP bundle before and after training sessions respectively.
