Marini Abdel Latif, Khan Raymond, Mundekkadan Shihab
Ministry of National Guards, Health Affairs.
BMJ Qual Improv Rep. 2016 Apr 4;5(1). doi: 10.1136/bmjquality.u205566.w2278. eCollection 2016.
Ventilator associated pneumonia (VAP) remains a worldwide harm associated with hospital acquired infection. Our VAP rate at King Abdulaziz Medical City was 4.0 per 1 000 patient days at baseline. All regulatory bodies continue to emphasize the importance of reducing these infections and include a guideline of practice recommendations to address them, notably the VAP bundle by the Institute for Healthcare Improvement. Our baseline compliance was low and measured to be 83%; this was perceived as an opportunity to work on revising our interventions in the ICUs. An improvement team gathered in 2013, and following the "model of improvement" methodology, along with a sequence of parallel PDSAs, they were able to increase compliance with the care bundle and sustain it above 95% for more than one year. This translated in a decrease in the VAP rate from 4.0 to 0.8 in all different multidisciplinary ICUs.
呼吸机相关性肺炎（VAP）仍然是一种与医院获得性感染相关的全球性危害。阿卜杜勒阿齐兹国王医疗城的VAP发生率在基线时为每1000个患者日4.0例。所有监管机构都继续强调减少这些感染的重要性，并纳入了针对这些感染的实践建议指南，特别是医疗改进研究所的VAP集束化方案。我们的基线依从性较低，经测量为83%；这被视为一个契机，可对重症监护病房（ICU）的干预措施进行修订。一个改进团队于2013年组建，遵循“改进模式”方法，并开展了一系列并行的计划-执行-检查-处理（PDSA）循环，他们能够提高对护理集束化方案的依从性，并将其维持在95%以上达一年多时间。这使得所有不同多学科ICU的VAP发生率从4.0降至0.8。
