Multiple Approaches Lead to Reduction of Ventilator-Associated Pneumonia in King Fahad Medical City in Riyadh

Background: Ventilator associated infections (VAP) is one of the serious hospital associated infections  affecting patients in ventilators

Objective: to describe outcome of three improvement modalities implimented succesively to decrease the rate of Ventilator Associated Pneumonia to less than 3 infections/1000 Ventilator days in KFMC ICU’s

Methods: Over the last 3.75 years (1/2007 – 10/2010) three successive intervention modalities implemented to decrease VAP in KFMC: IHI bundle, KFMC VAP bundle then organisms targeting strategy. Both process and outcome measures were monitored through implementation of three successive FOCUS-PDCA cycles.

Results:

During study period despite of increase in ventilator utilization rate (37% to 45%) gradual and steady reduction of VAP from 8.5 to 2.42 infections/1000 ventilator days reported. Great reduction of VAP caused by gram negative bacteria was clearly evident in 2010 after implementation of organisms targeting strategy. 3 out of 6 intensive care units reported zero infection for successive six months.

Years	Vent Days	UR	No. of Infections	IR
2007	8885	37.00	72	8.1
2008	10095	36.00	46	4.56
2009	11101	39.00	46	4.14
2010*	10336	45.00	25	2.42

Conclusions:

Multiple and successive FOCUS-PDCA approach succeeded to decrease VAP incidence by 70% in KFMC. Organism targeting strategy was the most effective intervention.