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VAP Bundle Readiness: A Review of Documented Oral Care Practices in an Intensive Care Unit
www.ajicjournal.org Vol. 37 No. 5
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Lessons Learned: Process and quality improvement initiatives do not need to be grandiose to be successful. A simple idea brought to the table by empowered individuals developed into a process for increased compliance to disinfection protocols along with increased job satisfaction. Initiating a training program to empower the transporters as Infection Prevention Coaches led to ownership of their work duties and the need to improve current practices for patient safety. This project highlights the importance of individuals becoming champions in their facility and working collaboratively on improvements that can sustain patient safety practices. Change must be embraced by all disciplines. Infection prevention is everybody’s responsibility.
Presentation Number: 13-167
VAP Bundle Readiness: A Review of Documented Oral Care Practices in an Intensive Care Unit Linda K. Goss, MSN, RN-BC, CIC, COHN-S, Infection Control, University of Louisville Hospital, Louisville, KY Background: Ventilator associated pneumonia (VAP) prevention includes routine oral care of the mechanically ventilated patient. The Centers for Disease Control and Prevention recommends a comprehensive oral care program be implemented as part of the pneumonia prevention guidelines. Documentation in the patient record provides evidence of this process. Frequently infection control serves as the lead in implementation of evidence based practice however baseline data is imperative prior to educating and implementation to determine the effectiveness of the program. Infection control recognized the need for assessment of current practice prior to developing and implementing a bundled approach to VAP prevention. Education efforts need to be streamlined to current practice deficits in order to appropriately address concerns prior to beginning any new process. Infection control frequently acts as the lead role in guideline implementation and did so in this situation. Methods: A study was conducted to determine the frequency of oral care of ventilated and non-ventilated patients admitted to an intensive care unit in an urban academic medical center. A retrospective chart review of randomly selected patients was performed and included inpatient visits from July 1 2007 thru December 31st 2007. The accessible patient population included all admitted patients during the study period. The charts were randomly selected using a computer generated table the population size was 200 patients which gave an estimated margin of error of 6.93%. A data collection tool was designed by infection control which included the ventilation status of the patient, demographics, admission date and diagnosis and documentation of oral care and frequency of oral care. Results: The sample consisted of 94 (64%) males and 53 (35%) females ranging in age from 13 to 95 years old. Neurosurgery admitted the most patients at 42% followed by Trauma at 23%. Data collected for this study examined information pertinent to oral care of the intensive care unit patient. SPSS was used to analyze the data. In the sample 54% of the patients were ventilated and 86% were not. The mean time between oral sessions for all patients was 3.2 hours and the mean length of time of documented oral care sessions for ventilated patients was 2.97 hours (SD 1.25 hours). While the data was not statistically significant it did correlate well with the noted concern over documentation and current practice. Conclusions: The research question for the study was: does the nursing documentation on the ICU critical care flowsheet reflect the inclusion of oral care for the prevention of ventilator associated pneumonia. Documentation was found on the examined records that 88.8% of patients received oral care however there were no differences for documentation due to gender, age or ventilator status. The documentation also lacked detail as to the type of oral care performed and was noted to be inconsistent among staff. Presentation Number: 13-168
Who is Responsible for Cleaning That? Judy Ptak, RN, MSN, Infection Prevention Practitioner; Laurie Tostenson, TQAM, Training and Quality Assurance Manager; Kathryn Kirkland, MD, Hospital Epidemiologist; EIleen Taylor, RN BSN, Infection Prevention Practitioner, Dartmouth-Hitchcock Medical Center, Lebanon, NH Issue: Thorough cleaning of the environment is considered an important part of preventing transmission of C.difficile and other pathogens. During investigation of an increased number of cases of C.difficile infection (CDI) in
E133
Lessons Learned: Process and quality improvement initiatives do not need to be grandiose to be successful. A simple idea brought to the table by empowered individuals developed into a process for increased compliance to disinfection protocols along with increased job satisfaction. Initiating a training program to empower the transporters as Infection Prevention Coaches led to ownership of their work duties and the need to improve current practices for patient safety. This project highlights the importance of individuals becoming champions in their facility and working collaboratively on improvements that can sustain patient safety practices. Change must be embraced by all disciplines. Infection prevention is everybody’s responsibility.
Presentation Number: 13-167
VAP Bundle Readiness: A Review of Documented Oral Care Practices in an Intensive Care Unit Linda K. Goss, MSN, RN-BC, CIC, COHN-S, Infection Control, University of Louisville Hospital, Louisville, KY Background: Ventilator associated pneumonia (VAP) prevention includes routine oral care of the mechanically ventilated patient. The Centers for Disease Control and Prevention recommends a comprehensive oral care program be implemented as part of the pneumonia prevention guidelines. Documentation in the patient record provides evidence of this process. Frequently infection control serves as the lead in implementation of evidence based practice however baseline data is imperative prior to educating and implementation to determine the effectiveness of the program. Infection control recognized the need for assessment of current practice prior to developing and implementing a bundled approach to VAP prevention. Education efforts need to be streamlined to current practice deficits in order to appropriately address concerns prior to beginning any new process. Infection control frequently acts as the lead role in guideline implementation and did so in this situation. Methods: A study was conducted to determine the frequency of oral care of ventilated and non-ventilated patients admitted to an intensive care unit in an urban academic medical center. A retrospective chart review of randomly selected patients was performed and included inpatient visits from July 1 2007 thru December 31st 2007. The accessible patient population included all admitted patients during the study period. The charts were randomly selected using a computer generated table the population size was 200 patients which gave an estimated margin of error of 6.93%. A data collection tool was designed by infection control which included the ventilation status of the patient, demographics, admission date and diagnosis and documentation of oral care and frequency of oral care. Results: The sample consisted of 94 (64%) males and 53 (35%) females ranging in age from 13 to 95 years old. Neurosurgery admitted the most patients at 42% followed by Trauma at 23%. Data collected for this study examined information pertinent to oral care of the intensive care unit patient. SPSS was used to analyze the data. In the sample 54% of the patients were ventilated and 86% were not. The mean time between oral sessions for all patients was 3.2 hours and the mean length of time of documented oral care sessions for ventilated patients was 2.97 hours (SD 1.25 hours). While the data was not statistically significant it did correlate well with the noted concern over documentation and current practice. Conclusions: The research question for the study was: does the nursing documentation on the ICU critical care flowsheet reflect the inclusion of oral care for the prevention of ventilator associated pneumonia. Documentation was found on the examined records that 88.8% of patients received oral care however there were no differences for documentation due to gender, age or ventilator status. The documentation also lacked detail as to the type of oral care performed and was noted to be inconsistent among staff. Presentation Number: 13-168
Who is Responsible for Cleaning That? Judy Ptak, RN, MSN, Infection Prevention Practitioner; Laurie Tostenson, TQAM, Training and Quality Assurance Manager; Kathryn Kirkland, MD, Hospital Epidemiologist; EIleen Taylor, RN BSN, Infection Prevention Practitioner, Dartmouth-Hitchcock Medical Center, Lebanon, NH Issue: Thorough cleaning of the environment is considered an important part of preventing transmission of C.difficile and other pathogens. During investigation of an increased number of cases of C.difficile infection (CDI) in