VAP Q&A

Questions and Answers for Ventilator Associated Pneumonia

 

  • 1. What is 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 a pneumonia.

 

  • 2. What are hospitals doing to improve VAP indicator rates?

A number of leading practices are available to support hospitals with their infection prevention and control efforts.

 

Norfolk General Hospital implemented Safer Healthcare Now best practice bundle for Ventilator associated pneumonia  Dec. of 2007. This bundle includes a number of interventions that have been proven to reduce the occurrence of VAP. Most recently we have improved our "oral care of ventilated patients" protocols to reflect current established best practices.

 

Safer Healthcare Now! (SHN) http://www.saferhealthcarenow.ca/EN/about/Pages/default.aspx   

SHN is a National grass roots initiative aimed at reducing the number of injuries and deaths related to adverse events, such as infections and medication incidents. 

 

Now that hospitals are publicly reporting their VAP cases, they have an additional opportunity to measure and track their quality and patient safety improvements.

 

  • 3. How serious is VAP for hospital patients?

VAP is a serious lung infection that is associated with a higher mortality rate. VAP can occur in patients who need to be on a ventilator for at least 48 hours or more.  The majority of patients in a hospital who require a ventilator are cared for in the ICU. Because patients in an ICU are already quite ill, they have increased risk factors for infection. If a patient develops VAP, they will have to stay longer in the ICU, and will be ventilated for longer periods of time. Overall, they will spend more time in the hospital.

 

  • 4. How is VAP treated?

Since VAP is caused by a bacterial infection in the lungs, it is treated using antibiotics. Sometimes it can be difficult to ascertain if a patient has developed a VAP, as they are already critically ill, and may have a pre-existing infection.  Professional care teams in ICUs do their best to use leading practices to prevent a VAP from occurring.

 

And now that hospitals are publicly reporting their VAP cases, they have an additional opportunity to measure and track their quality and patient safety improvements.

 

  • 5. What happens when you get VAP?

Patients with VAP show symptoms of either a fever or lower body temperature. The mucous or phlegm that is brought up from their lungs is infected.

 

  • 6. Is VAP contagious?

Since VAP is caused by bacteria in the lungs, and patients in the ICU are very ill to begin with, the bacteria could be contagious if preventative strategies are not implemented.  To prevent the spread of pneumonia to other patients, health care providers practice proper hand hygiene techniques, and will discontinue mechanical ventilation as soon as possible when patients are ready to breathe on their own.

 

  • 7. Do patients contract VAP because of improper sterilization of hospital rooms or equipment?

When a patient requires mechanical ventilation, sterile equipment, and sterile techniques are used to insert the breathing tube. When ICU staff take care of a ventilated patient, they try to keep the area around the breathing tube as clean as possible. Patients who are on a ventilator are very sick to begin with, and are more prone to infection.

  • 8. Can you only get VAP in an ICU?

 

VAP can occur in anyone who has been on a ventilator for more than 48 hours. Some people who have certain health problems are chronically ventilated (i.e., all the time). They may occur in settings other than a hospital, and these people/patients can develop VAP too.

 

We are only collecting VAP rates in a hospital ICU, since patients are more likely to be ventilated in this location.

 

Patients should know that their hospital is safe, that the care received is top-notch, and that every effort is made to ensure patients receive the highest quality of care possible.

 

The analysis of VAP cases over time will certainly provide helpful information that we can use to make quality improvements in our organization. We look forward to working with our health professionals to make those improvements in the time ahead.