Process improvement plan for the reduction of nosocomial pneumonia in patients on ventilators.

Pneumonia is a frequently occurring nosocomial infection that often results in serious illness and death of the patient. In one hospital, after the discovery of a ventilator-associated nosocomial infection rate that was higher than the national standard, a multidisciplinary team was formed. The team followed the FOCUS-PDCA model of quality improvement to identify methods to improve the nosocomial pneumonia infection rate for mechanically ventilated patients. Three areas of potential improvement were identified: trial of a closed suction system, policies and procedures for cleaning of ventilators, and staff education. Additionally, a research project was conducted to identify predictors of ventilator-associated nosocomial pneumonia. These projects resulted in a reduction of the ventilator-associated nosocomial pneumonia infection rate to 8.3/ 1,000 ventilator days and a cost savings of more than $580,000.