Public Reporting Ventilator Associated Pneumonia

Patient safety remains the most important priority for Norfolk General Hospital and this involves ensuring that patients are not at risk for contracting healthcare-associated infections. We are committed to transparency. Beginning April 30, 2009, Norfolk Hospital is reporting its quarterly Central Line Infection rate. The first reporting period will cover the months of January, February and March 2009.


What is a Ventilator Associated Pneumonia (VAP)?

For our public reporting purposes, ventilator associated pneumonia (VAP) is defined as a pneumonia (lung infection) occurring in patients in an intensive care unit (ICU), requiring, external mechanical breathing support (a ventilator) intermittently or continuously, through a breathing tube for more than 48 hours.


VAP can develop in patients for many reasons. Because they are relying on an external machine to breath, their normal coughing, yawning, and deep breath reflexes are suppressed. Furthermore, they may have a depressed immune system, making them more vulnerable to infection.  ICU teams have many ways to try to assist patients with these normal breathing reflexes, but despite this, patients are still at risk for developing pneumonia


Posting VAP Rates


All hospitals with ICUs are required to report into the Critical Care Information System (CCIS) - a centralized data collection system where hospitals report a variety of critical care information. This information is used to calculate the VAP data that must be publicly reported.


 Ontario hospitals with ICUs are posting their quarterly VAP rate and case count for those infections acquired in their facility, using the following formula:

         Total # of ICU cases of VAP after 48 hours of mechanical ventilation___  X 1000

           Total # of ventilator days for ICU patients 18 years and older

The VAP rate for the fourth quarter of 2011/2012 is 0, we have had no VAPs for this quarter

What can patients do to help reduce their chances of infection?

Frequent hand cleaning is a good way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.


More patient-specific information is available at and and


  Fact Sheet VAP                      Questions and Answers about VAP

Hand Hygiene copy

Prevent the Spread of Germs!