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 T48 {{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 ===
{{DJ|
see [[Invasive mechanical ventilation at 2300 hrs (concept)]]
* We have another indicator [[Duration of Mechanical Ventilation]]. Is it defined the same way? If so, should this be defined only once, there, and this link to it?
 
}}
=== VAP ===
**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.
* 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
**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.
* Aug 2009 to Dec 2018, the dates when VAP occurred were taken from the Tmp project [[QA Infection]].
**June 1988 to Dec 2012 - Daily data for Invasive Mech Vent are taken on [[TISS76-Form]] elements # 29 or 30 which are saved at
S:\MED\MED_CCMED\CCMDB\Legacy_TMS_Data\Legacy_TMS_Data.mdb
* 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==

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

Related articles

Related articles:
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