Computer display helps reduce the rates of ventilator-associated pneumonia in surgical intensive care units

Research Activities, April 2010

Patients in surgical intensive care units (SICU) often have their breathing assisted by a ventilator. However, such patients run the risk of developing ventilator-associated pneumonia (VAP), which can result in death as well as a longer hospital stay and higher costs. Using an innovative computer screensaver can help SICU personnel monitor these patients more effectively, suggests a new study. The real-time "dashboard" promotes compliance with the ventilator bundle, a set of patient care practices designed to prevent VAP.

The setting for this study was a 21-bed SICU at a large academic tertiary care center. Every desktop computer in the SICU was equipped with the electronic VAP dashboard. It graphically displays compliance with the ventilator bundle parameters for each patient at various time intervals for each item. Each measure is highlighted green for compliance, red for being out of compliance, or yellow for a parameter that is due for attention.

Compliance with the ventilator bundle significantly improved with the VAP dashboard, increasing from 39 percent in August 2007 to 89 percent in July 2008. After the dashboard was introduced, the rate of VAP decreased from 15.2 events to 9.3 events per 1,000 ventilator days. The researchers point out that complete compliance with the ventilator bundle parameters has also increased. Currently, nearly 90 percent of all SICU patients receive every parameter simultaneously and continuously. Despite the lower rate of VAP after implementing the dashboard, further reductions are needed, note the researchers. Additional measures, such as specially designed endotracheal tubes, may help lower the rate of VAP even further. The study was supported in part by the Agency for Healthcare Research and Quality (HS13833).

See "Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle," by Victor Zaydfudim, M.D., M.P.H., Lesly A. Dossett, M.D., M.P.H., John M. Starmer, M.D., and others in the Archives of Surgery 144(7), pp. 656-662, 2009.

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