Duration of Mechanical Ventilation

Duration of Mechanical Ventilation is the average number of days being spent by ICU patients on mechanical ventilation.

Indicators
Indicator:	Duration of Mechanical Ventilation
Created/Raw:	Created
Program:	Critical Care
Start Date:	Jan 1 2013
End Date:
Reports:	Critical Care Program Quality Indicator Report

QI domain

Effective
Efficient

Reported as

Days (mean)

Significance

Ventilation duration can be considered a surrogate marker of interrelated factors such as : ICU patients characteristics (acuity, comorbidity, premorbid functional status), structural and process-related aspects of ICU care (staffing ratios, staff expertise, processes for effective ventilator).

Sampling Plan / Procedure

Inclusion Criteria

100% sampling for all patients on mechanical ventilation. Mechanical ventilation includes:

Invasive Mechanical Ventilation via ET Tube or tracheostomy
Non-invasive CPAP or BIPAP

Exclusion Criteria

Patients who are not on mechanical ventilation

Frequency

Daily recording of dates a patient being on mechanical ventilation
Total number of ICU patients and ICU days being on mechanical ventilation are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
Time Reference for month, quarter or year can be based on ICU admission dates or ICU discharge dates. For the Director reports, the discharge dates are used as the time of reference.

Definition and Derivation

Numerator

Num = Total Mechanical Vent Days in a given period

Denominator

Denom =Number of ventilated patients on the same period as the numerator

Formula

Duration of Mechanical Ventilation in days = Num / Denom

Example

Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
Number of patients who have discharge dates from Jan 1, 2017 to March 31, 2017 and who were on mechanical ventilation at HSC MICU = 158
Total Days these patients are on mechanical ventilation (invasive and/or non-invasive) = 981
- (if a patient had both Invasive and non-invasive Mechanical ventilation in a day, this is counted as one day only.)
Duration of Mechanical Ventilation in days = 981 / 158 = 6.2 days

Data Sources

Prior Jan 2013, daily data for Invasive and non invasive mechanical ventilation are taken from the following TISS76-Legacy elements

T29 A/C, SIMV, PSV with intermittent or continuous muscle relaxant/sedation. See: TISS76-Legacy
T30 A/C, SIMV, PSV without muscle relaxant/sedation. See: TISS76-Legacy
T31 Spontaneous CPAP or BIPAP

The TISS form is being marked daily for the first 10 days by ICU bed side nurses and quality checked by the Database Data Collectors. For LOS > 10, if any of the above TISS item is marked on the 10th day, assume that the item is being marked until one day before discharge date.

Jan 2013 to Sept 2020, daily data for Invasive and non invasive mechanical ventilation are taken from the following TISS28 elements

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 elements are collected as part of the CCI Collection, before this they were part of TISS28 Data.mdb.

SAS Program

Part of S:\MED\CCMED\S:\MED\CCMED\Julie\SAS_CFE\CC_reports\ChartReport\prepCCChart.sas