Achieving and Sustaining Ventilator-Associated Pneumonia–Free Time among Intensive Care Units (ICUs): Evidence from the Keystone ICU Quality Improvement Collaborative

2013 ◽  
Vol 34 (7) ◽  
pp. 740-743 ◽  
Author(s):  
Dany S. Matar ◽  
Julius C. Pham ◽  
Thomas A. Louis ◽  
Sean M. Berenholtz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Retrospective Analysis ◽  
Intensive Care Units ◽  
Free Time ◽  
Ventilator Associated Pneumonia ◽  
Quality Improvement Collaborative ◽  
Zero Rate

Our retrospective analysis of the Michigan Keystone intensive care unit (ICU) collaborative demonstrated that adult ICUs could achieve and sustain a zero rate of ventilator-associated pneumonia (VAP) for a considerable number of ventilator and calendar months. Moreover, the results highlight the importance of adjustment for ventilator-days before comparing VAP-free time among ICUs.

scholarly journals Modifiable risk factors of ventilator-associated pneumonia in non-intensive care unit versus intensive care unit

2021 ◽  
Vol 15 (10) ◽  
pp. 1471-1480
Author(s):  
Patpong Udompat ◽  
Daravan Rongmuang ◽  
Ronald Craig Hershow
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Proton Pump ◽  
Multidrug Resistant ◽  
Surgical Intensive Care Unit ◽  
Ventilator Associated Pneumonia ◽  
Neurosurgical Patients

Introduction: Ventilator-associated pneumonia patients are treated in non-intensive care units because of a shortage of intensive care unit beds in Thailand. Our objective was to assess whether the type of unit and medications prescribed to the patient were associated with ventilator‑associated pneumonia and multidrug resistant ventilator‑associated pneumonia. Methodology: A matched case-control study nested in a prospective cohort of mechanical ventilation adult patients in a medical-surgical intensive care unit and five non-intensive care units from March 1 through October 31, 2013. The controls were randomly selected 1:1 with cases and matched based on duration and start date of mechanical ventilation. Results: 248 ventilator-associated pneumonia and control patients were analyzed. The most common bacteria were multidrug resistant Acinetobacter baumannii (82.4%). Compared with patients in the intensive care unit, those in the neurosurgical/surgical non-intensive care units were at higher risk (p = 0.278). Proton pump inhibitor was a risk factor (p = 0.011), but antibiotic was a protective factor (p = 0.054). Broad spectrum antibiotic was a risk factor (p < 0.001) for multidrug resistant ventilator-associated pneumonia. Conclusions: Post-surgical and neurosurgical patients treated in non-intensive care unit settings were at the highest risk of ventilator-associated pneumonia. Our findings suggest that alternative using proton pump inhibitors should be considered based on the risk-benefit of using this medication. In addition, careful stewardship of antibiotic use should be warranted to prevent multidrug resistant ventilator-associated pneumonia.

CNE Article: Safety Culture In Australian Intensive Care Units: Establishing A Baseline For Quality Improvement

2013 ◽  
Vol 22 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Wendy Chaboyer ◽  
Di Chamberlain ◽  
Karena Hewson-Conroy ◽  
Bernadette Grealy ◽  
Tania Elderkin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Intensive Care Units ◽  
Working Conditions ◽  
Safety Culture ◽  
Hospital Management ◽  
Workplace Safety ◽  
Nurse Leaders ◽  
Safety Attitudes

Background Workplace safety culture is a crucial ingredient in patients’ outcomes and is increasingly being explored as a guide for quality improvement efforts. Objectives To establish a baseline understanding of the safety culture in Australian intensive care units. Methods In a nationwide study of physicians and nurses in 10 Australian intensive care units, the Safety Attitudes Questionnaire intensive care unit version was used to measure safety culture. Descriptive statistics were used to summarize the mean scores for the 6 subscales of the questionnaire, and generalized-estimation-equations models were used to test the hypotheses that safety culture differed between physicians and nurses and between nurse leaders and bedside nurses. Results A total of 672 responses (50.6% response rate) were received: 513 (76.3%) from nurses, 89 (13.2%) from physicians, and 70 (10.4%) from respondents who did not specify their professional group. Ratings were highest for teamwork climate and lowest for perceptions of hospital management and working conditions. Four subscales, job satisfaction, teamwork climate, safety climate, and working conditions, were rated significantly higher by physicians than by nurses. Two subscales, working conditions and perceptions of hospital management, were rated significantly lower by nurse leaders than by bedside nurses. Conclusions Measuring the baseline safety culture of an intensive care unit allows leaders to implement targeted strategies to improve specific dimensions of safety culture. These strategies ultimately may improve the working conditions of staff and the care that patients receive. (American Journal of Critical Care. 2013;22:93–103)

Using Economic Information in a Quality Improvement Collaborative

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e411-e418
Author(s):  
Jeannette Rogowski
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Treatment Costs ◽  
Quality Improvement Collaborative ◽  
Intensive Care Unit Treatment ◽  
Economic Information

This article provides an overview of neonatal intensive care unit treatment costs for hospitals that participated in the Neonatal Intensive Care Quality Improvement Collaborative Year 2000 (NIC/Q 2000) quality improvement collaborative and discusses how economic information can be used in quality improvement efforts. Detailed information on neonatal intensive care unit treatment costs is presented for 29 hospitals that participated in the NIC/Q 2000 collaborative. The sample consists of 6797 very low birth weight infants (1500 g or less at birth) with admission dates between January 1, 1997, and December 31, 1998. Information on median treatment cost per infant, ancillary costs, accommodation costs, length of stay, and cost per day is presented. In addition, ancillary costs are further disaggregated into those for respiratory therapy, laboratory, radiology, pharmacy, and all other ancillary services. The role of level of care and other factors that influence treatment costs are then explored.

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