Ventilator Associated Pneumonia Rate: Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
| description = Ventilator Associated Pneumonia (VAP) Rate is the number of cases of (old:[[VAP - Ventilator Associated Pneumonia]], new: [[Pneumonia, ventilator-associated (VAP)]]) per 1000 invasive ventilator days.
| description = Ventilator Associated Pneumonia ([[#VAP]]) Rate is the number of cases of per 1000 invasive ventilator days.
| indicator_name = Ventilator Associated Pneumonia (VAP) Rate
| indicator_name = Ventilator Associated Pneumonia (VAP) Rate
| created_raw = Created
| created_raw = Created
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==Reported as==
==Reported as==
Number of cases of [[Pneumonia, ventilator-associated (VAP)]] per 1000 Ventilator-days
Number of cases of [[#VAP]] per 1000 Ventilator-days


==Significance==
==Significance==
*[[VAP - Ventilator Associated Pneumonia|VAP]] is a device-associated infection, the device being the artificial airway-ventilator-circuit system. [[VAP - Ventilator Associated Pneumonia|VAP]] is associated with worse patient outcomes and higher costs.
*[[#VAP]] is a device-associated infection, the device being the artificial airway-ventilator-circuit system. [[#VAP]] is associated with worse patient outcomes and higher costs.
*Factors affecting the incidence of [[VAP - Ventilator Associated Pneumonia|VAP]] include those from patients (severity of illness, comorbidities, etc.) and processes of care.
*Factors affecting the incidence of [[#VAP]] include those from patients (severity of illness, comorbidities, etc.) and processes of care.
*[[VAP - Ventilator Associated Pneumonia|VAP]] rate is a measure of the incidence of [[VAP - Ventilator Associated Pneumonia|VAP]].
*[[#VAP]] rate is a measure of the incidence of [[#VAP]].


==Sampling Plan / Procedure==
==Sampling Plan / Procedure==
===Inclusion Criteria===
===Inclusion Criteria===
*100% sampling for all patients on invasive mechanical ventilation as indicated by presence of {{TISS w Nr | Invasive mechanical ventilation at 2300 hrs (TISS Item)}}
*100% sampling for all patients on invasive mechanical ventilation as indicated by presence of [[#Ventilator Days at 23 HR]]
*100% sampling for all cases with VAP incidence following the criteria listed in [[VAP - Ventilator Associated Pneumonia]]
*100% sampling for all cases with VAP incidence following the criteria listed in [[#VAP]]
 
===Exclusion Criteria===
===Exclusion Criteria===
Exclude non-invasive ventilation.
Exclude non-invasive ventilation.
===Frequency===
===Frequency===
* Recording the date the [[VAP - Ventilator Associated Pneumonia|VAP]] occurred.
* Recording the date the [[#VAP]] occurred.
* Daily recording of dates of patient being on invasive mechanical ventilation at 2300 HR
* Daily recording of dates of patient being on invasive mechanical ventilation at 2300 HR
* Total number of ventilated days are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
* Total number of ventilated days are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
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==Definition and Derivation==
==Definition and Derivation==
===Numerator===
===Numerator===
Num = Total [[VAP - Ventilator Associated Pneumonia|VAP]] Cases in a calendar period
Num = Total [[#VAP]] Cases in a calendar period
===Denominator===
===Denominator===
Denom =Total Vent Days on the same period as the numerator
Denom =Total Vent Days on the same period as the numerator
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==Data Sources==
==Data Sources==
*Daily data for Invasive are taken on [[TISS28]] element {{TISS w Nr | Invasive mechanical ventilation at 2300 hrs (TISS Item)}}.  The TISS form is being marked daily by ICU bed side nurses and quality checked by the Database Data Collectors. Starting Oct 1, 2020, the above TISS28 element is collected as part of the CCI Collection, before this they were part of TISS28 Data.mdb.
=== Ventilator Days at 23 HR ===
* Starting 2019, VAP is part of the ICD10 collection with code J95.88 [[Pneumonia, ventilator-associated (VAP)]] under the Acquired Diagnosis / Complication. The date is the [[Dx Date]] of the [[VAP - Ventilator Associated Pneumonia]] diagnosis
see [[Invasive mechanical ventilation at 2300 hrs (concept)]]
** Before 2019, the dates when VAP occurred were taken from the Tmp project [[QA Infection]].
 
=== VAP ===
* Starting Jan 2019, VAP is part of the ICD10 collection with code J95.88 [[Pneumonia, ventilator-associated (VAP)]] under the Acquired Diagnosis / Complication. The date is the [[Dx Date]] of the [[VAP - Ventilator Associated Pneumonia]] diagnosis
* Aug 2009 to Dec 2018, the dates when VAP occurred were taken from the Tmp project [[QA Infection]].


==SAS Program==
==SAS Program==
* The SAS program to get the VAP is X:\Julie\SAS_CFE\CFE_macros\Pre_ICD10_AcqDx.sas
* The SAS program to get the VAP is X:\Julie\SAS_CFE\CFE_macros\Pre_ICD10_AcqDx.sas
* The SAS program to get the Ventilator Days is X:\Julie\SAS_CFE\CFE_macros\\Prep_CCI_TISS.sas
* The SAS program to get the Ventilator Days is X:\Julie\SAS_CFE\CFE_macros\Read_TISS76_TISS28_TISSinCCI.sas
*Part of X:\Julie\SAS_CFE\CC_reports\ChartReport\prepCCChart.sas
** macro '''%tisscci23hr''' shows the generation of Vent present at 23 HR
* The SAS program to get the VAP rate is X:\Julie\SAS_CFE\CFE_macros\VAPCLICAM.sas


==Report Users==
==Report Users==

Latest revision as of 15:34, 2022 March 16

Ventilator Associated Pneumonia (#VAP) Rate is the number of cases of per 1000 invasive ventilator days.

Indicators
Indicator: Ventilator Associated Pneumonia (VAP) Rate
Created/Raw: Created
Program: Critical Care
Start Date: Jan 1 2013
End Date:
Reports: Critical Care Program Quality Indicator Report, Directors Quarterly and Annual Report (Critical Care), STB ICUs VAP Rate, CLIBSI Rate Summary, WRHA ICU Hospital-Acquired Conditions


  • Cargo


  • SMW:
  • Categories
  • Default form:

Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital

QI domain

  • Safe

Reported as

Number of cases of #VAP per 1000 Ventilator-days

Significance

  • #VAP is a device-associated infection, the device being the artificial airway-ventilator-circuit system. #VAP is associated with worse patient outcomes and higher costs.
  • Factors affecting the incidence of #VAP include those from patients (severity of illness, comorbidities, etc.) and processes of care.
  • #VAP rate is a measure of the incidence of #VAP.

Sampling Plan / Procedure

Inclusion Criteria

  • 100% sampling for all patients on invasive mechanical ventilation as indicated by presence of #Ventilator Days at 23 HR
  • 100% sampling for all cases with VAP incidence following the criteria listed in #VAP

Exclusion Criteria

Exclude non-invasive ventilation.

Frequency

  • Recording the date the #VAP occurred.
  • Daily recording of dates of patient being on invasive mechanical ventilation at 2300 HR
  • Total number of ventilated days are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
  • Time Reference is calendar month, quarter or year.

Definition and Derivation

Numerator

Num = Total #VAP Cases in a calendar period

Denominator

Denom =Total Vent Days on the same period as the numerator

Formula

VAP Rate = Num / Denom * 1000

Example

  • Time Reference: Calendar Dates from Jan 1, 2017 to March 31, 2017
  • Total VAP cases = 5
  • Total days patients are on invasive ventilator at 2300 HR = 688
  • VAP Rate per 1000 days = (5 / 688) * 1000 = 7.3%

Data Sources

Ventilator Days at 23 HR

see Invasive mechanical ventilation at 2300 hrs (concept)

VAP

SAS Program

  • The SAS program to get the VAP is X:\Julie\SAS_CFE\CFE_macros\Pre_ICD10_AcqDx.sas
  • The SAS program to get the Ventilator Days is X:\Julie\SAS_CFE\CFE_macros\Read_TISS76_TISS28_TISSinCCI.sas
    • macro %tisscci23hr shows the generation of Vent present at 23 HR
  • The SAS program to get the VAP rate is X:\Julie\SAS_CFE\CFE_macros\VAPCLICAM.sas

Report Users

  • Critical Care Directors, Critical Care Unit Managers and WRHA Outcome Improvement Team Committee
  • St Boniface Cardiac Sciences Program (STB site only)
  • HSC Infection Prevention & Control (HSC site only)
  • WRHA Infection Prevention & Control

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