Reducing Ventilator-Associated Events: A Quality Improvement Project

Mechanical ventilation is lifesaving therapy in intensive care units but can increase patients' risk for ventilator-associated events. These events are associated with longer intensive care unit and hospital stays, more ventilator days, and increased mortality rates. To meet internal and national benchmarks, the number of ventilator-associated events in a 15-bed intensive care unit needed to be decreased. A multidisciplinary team used the define, measure, analyze, improve, and control framework in this quality improvement project at a community hospital. Evidence-based guidelines for preventing ventilator-associated events were incorporated into interventions, which included discussion of ventilator settings in daily rounds, additional evening rounds, and staff education. The team reinforced education, defined roles in the care of patients receiving mechanical ventilation, and implemented communication strategies between departments. Preimplementation data from the calendar year 2018 were compared with postimplementation data from the calendar year 2019. The ventilator-associated event incidence rate decreased from 25.58 per 1000 ventilator days in 2018 to 5.29 per 1000 ventilator days in the third quarter of 2019. The goal rate (≤ 18.00 events per 1000 ventilator days) was sustained for the year 2019. The lower rates of ventilator-associated events met internal and national benchmarks after the implementation of interventions. Safety was enhanced for patients who may have had unexpected outcomes related to a ventilator-associated event. The creation and implementation of clear, specific communication and processes for successfully managing patients receiving mechanical ventilation decreased the rate of ventilator-associated events.