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Multidisciplinary Protocol Eliminates VAP
A study of a new multidisciplinary protocol that has all but eliminated such infections at one hospital was reported today at the 2010 Annual Clinical Congress of the American College of Surgeons.
Some estimates have put the incidence of ventilator-associated pneumonia, or VAP, at 250,000 to 300,000 cases a year in the United States, approximately five to 10 cases per 1,000 hospital admissions. Riad Cachecho, MD, MBA, FACS, studied the use of what is called a VAP bundle at Crozer-Chester Medical Center (CCMC) in Chester, PA, that led to elimination of VAP by the end of a four-year study period. "It is not impossible to eradicate ventilator-associated pneumonia from a trauma unit," reported Dr. Cachecho, medical director of the Crozer Regional Trauma Center.
VAP is defined as a lower airway infection that occurs more than 48 hours after a patient has been placed on a breathing tube. VAP has been linked in some studies to longer patient stays in intensive care units and up to $40,000 in increased costs per individual patient, according to Dr. Cachecho.
The VAP bundle that was devised at CCMC consists of several steps in the care of the trauma unit patient, including elevating the patient''s head. Nurses also clean the patient''s mouth every two hours, rinsing the mouth with a germicidal mouthwash every six hours.
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