Eating the Elephant Conference

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VAP Prevention Strategy at St. Josephs Health
Centre

• Eating the Elephant Conference
• June 17th, 2008

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Team Composition

• Intensivist ? Dr. Joanne Meyer
• ICU Patient Care Manager ? Julie Ninnis
• ICU RN ? Janice Klutt
• Respiratory Therapist ? Jeff Dionne
• Infection Control Practitioner ? Diana Petrusic
• Pharmacy ? Tracey Lawson

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Aim of Team

• October 2005 ? Decrease VAP by 50 over 12 months
• Individual aspects of bundle
• Monthly audits (Frequent PDSA)

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Success Measures- HOB

• Initial compliance
• Challenges
• Documentation redesign ? Interprofessional
  approach
• Monthly audits ? Cross referenced

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HOB Results
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HOB Results January 2007
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HOB Results September 2007
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Spontaneous Breathing Trials (SBT)

• SBT initiated July 2006
• Education/ Assessment
• Holding of feeds
• Monthly audits
• Time to extubation

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Sedation Protocol

• Sedation Vacation
• Goal of Sedation Protocol
• Challenges
• Future Direction

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Small Bore Feeding Tube

• Orogastric tubes
• Oral Hygiene
• Education
• Opportunities for improvement

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Hi-Lo EVAC ETT

• Removal of Subglottic Secretions
• Continuous vs. Intermittent
• Size Differential
• Safety Initiatives
• Cost Analysis
• Implementation

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VAP Rates at SJHC
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VAP Organisms 2007
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Next Steps

• Implementation of Hi-Lo EVAC tube
• Standard for Oral Hygiene
• Analysis of Sedation Protocol
• Goal to have zero VAP through 2008

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Contact information

• Dr. Joanne Meyer, Intensivist meyerj_at_stjoe.on.ca
• Janice Klutt, ICU RN Team Leader
  kluttj_at_stjoe.on.ca
• Diana Petrusic, Infection Control Practitioner,
  petrud_at_stjoe.on.ca
• Jeff Dionne, Clinical Co-ordinator Respiratory
  Therapy dionnj_at_stjoe.on.ca

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Thank You!