Ventilator Associated Pneumonia Rate

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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


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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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