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==
* Ventilator Days
=== Ventilator Days at 23 HR ===
**Starting Oct 1, 2020, the above TISS28 element is collected as part of the CCI Collection but not at 2300HR , before this they were part of TISS28 Data.mdb. The presence of Vent at 2300 hour is imputed or assigned by inference using this method - if patient is present at 23HR and the [[TISS28]] element {{TISS w Nr | Invasive Mechanical Ventilation (TISS Item)}}  is marked, then the patient is assumed to have ventilator at 2300 hour.
see [[Invasive mechanical ventilation at 2300 hrs (concept)]]
**Jan 2013 to Sept 2020 - 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.
 
**June 1988 to Dec 2012 - Daily data for Invasive Mech Vent are taken on [[TISS76-Form]] elements # 29 or 30 which are saved at
=== VAP ===
S:\MED\MED_CCMED\CCMDB\Legacy_TMS_Data\Legacy_TMS_Data.mdb
* 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
* VAP  
* Aug 2009 to Dec 2018, the dates when VAP occurred were taken from the Tmp project [[QA Infection]].
** 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 {{S:\MED\MED_CCMED}}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
* The SAS program to get the Ventilator Days is {{S:\MED\MED_CCMED}}Julie\SAS_CFE\CFE_macros\Read_TISS76_TISS28_TISSinCCI.sas
** macro '''%tisscci23hr''' shows the generation of Vent present at 23 HR
** 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
* The SAS program to get the VAP rate is {{S:\MED\MED_CCMED}}Julie\SAS_CFE\CFE_macros\VAPCLICAM.sas


==Report Users==
==Report Users==
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{{Related Articles}}
{{Related Articles}}


[[Category: TISS28]]
[[Category:TISS28]]
[[Category: VAP - Ventilator Associated Pneumonia]]
[[Category:VAP - Ventilator Associated Pneumonia]]
[[Category: Data Use]]
[[Category:Data Use]]
[[Category: Reporting]]
[[Category:Reporting]]
[[Category: Statistical Analysis]]
[[Category:Statistical Analysis]]