1. Evelyn Mello, BSMT, (ASCP) MS, CIC Infection Control Practitioner

2. Ventilator-Associated Pneumonia MetroWest Medical Center’s Journey MWMC is a 2-hospital system  Framingham Union Hospital in Framingham  Leonard Morse Hospital in Natick 269 bed community teaching hospital 2 critical care units, total of 21 beds 24/7 Intensivist / Pulmonologist ICU / CCU coverage 4 days average length of stay on ventilator

3. Ventilator-Associated Pneumonia Project Background  Started in 2005 – IHI 100K Lives Campaign  Review of our VAP rates – In 2004 – 4 VAP cases, 2.8/1000 vent. days  VAP Bundle and education / Implementation Aim  Reduce VAP at MWMC to 0% within 1 year

4. Ventilator-Associated Pneumonia Project Multidisciplinary Team Approach  ICU/CCU Staff, Respiratory Therapy, Intensivists, Infectious Disease MDs, Infection Control Practitioners, Pharmacy, Quality Developed VAP Bundle Checklist and signage  Additional Interventions Increased use of non-invasive ventilation – CPAP Chlorhexidine Mouthwash Spontaneous breathing trial done on all vent. patients daily Fast-track all vent. patients – wean and extubate quickly Resp. staff monitoring of VAP bundle with vent. checks (q 2 hours) Lessons Learned  Teamwork leads to Positive Patient Outcomes & Quality Patient Care