The U.S. Department of Health and Human Services and groups such as the Society of Critical Care Medicine are honoring 37 facilities nationwide that have consistently met the target for avoiding ventilator-associated pneumonia, infections from a central line or both.
University, the only Georgia facility named, will be honored for its Outstanding Leadership Award today. It lowered its rate of ventilator-associated pneumonia by 96 percent and achieved targets for 25 months or more.
“That’s huge,” said Dr. Carol Thompson, the secretary of the Society for Critical Care Medicine and a professor of critical care nursing at the University of Tennessee Health Science Center. “Lives saved, suffering saved – it’s huge.”
University has achieved a rate that was unthinkable years ago, said Heidi Nelson, its director of performance improvement and infection prevention.
“Our rate now is zero,” she said. This Thursday, the hospital will have gone 365 days without a case of ventilator-associated pneumonia.
A 2005 review in the journal Critical Care Medicine found the rate for those infections was between 10 and 20 percent in patients who were on a ventilator for more than 48 hours, adding six days in the ICU and making the patient twice as likely to die.
From the hospital’s standpoint, that adds about $30,000 to $40,000 in cost per patient, in addition to the suffering it causes, Thompson said.
“The stress on the family, the stress on the patient. Pneumonia is a very uncomfortable kind of thing to have to go through,” she said.
University tackles the problem daily and routinely gives ventilator patients a “sedation vacation,” in which sedation is lessened to see whether the patient might be able to breathe if the tube is taken out, Nelson said.
“The longer they are on the ventilator, the higher the risk of (infection),” she said.
University has also had success switching to a different tube that allows better suctioning of fluids before they get to the lungs, Thompson said, and with simple things such as brushing the patient’s teeth to reduce the bacterial buildup.
“It is just amazing how much that has helped, too,” she said.
Reducing the rate is important now and in the future – by 2013, it is one of the measures Medicare will look at in deciding payment to hospitals, Nelson said.
It is simply a matter of good practice, she said.
“Every patient is different,” Nelson said. “But if you can really standardize the evidence-based practices and build that into our daily work life so that every patient gets it every time, that’s what makes the difference.”