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Ventilation-acquired Pneumonia

Definition

Ventilation-acquired pneumonia  (VAP) is defined as a pneumonia (lung infection) occurring in patients in an intensive care unit (ICU) requiring external mechanical breathing support (a ventilator) intermittently or continuously through a breathing tube for more than 48 hours.
 
VAP can develop in patients for many reasons. Because they are relying on an external machine to breath, their normal coughing, yawning, and deep breath reflexes are suppressed. Furthermore, they may have a depressed immune system, making them more vulnerable to infection.
 
ICU teams have many ways to try to assist patients with these normal breathing reflexes, but despite this, patients are still at risk for developing pneumonia.

Performance

Link to the North York General Hospital VAP rate.

North York General regularly monitors and reviews infection rates and uses this information to execute best practice protective measures and continually improve patient care and safety.
 
All hospitals with ICUs required to report into the Critical Care Information System — a centralized data collection system where hospitals report a variety of critical care information — must publicly report the VAP indicator data. This includes North York General.

Hospitals are posting their quarterly VAP rate and case count for those infections acquired in their facility, using the following formula:
total # of ICU cases of VAP after 48 hours of mechanical ventilation X 1000
total # of ventilator days for ICU patients 18 years and older

Learn more about patient safety indicators on the Health Quality Ontario website.

What we are doing to improve patient safety

Patient safety remains the most important priority for North York General and this involves ensuring that patients are not at risk for contracting health care-associated infections.

We have a number of practices in place to help prevent and control infections. As of April 30, 2009, all Ontario hospitals were required to post quarterly VAP rates to further promote accountability and transparency within the health system. In addition, North York General is improving patient safety in a number of ways including:
 
  • Adopting and executing the Safer Healthcare Now practices to prevent VAP infections and death

  • Developing a comprehensive system for screening and surveillance of high-risk patients for infectious syndromes (e.g. diarrhea, meningitis, etc.) and antibiotic-resistant organisms (Methicillin-resistant Staphylococcus aureus or MRSA, Vancomycin-resistant Enterococci or VRE, C. difficile, etc.)

  • Enhancing our Infection Prevention and Control Program

  • Actively implementing an aggressive hand washing campaign across the entire hospital to dramatically increase hand washing compliance rates
  • Engaging North York General staff in developing plans to respond to pandemic influenza

  • Actively participating in community education by hosting our region's Infection Prevention and Control Network.