Case Study 5
At a local hospital, the QI team identified three ventilator-acquired pneumonia (VAP) cases during the third quarter. This presents a huge concern for the hospital because VAPs are considered preventable and nonreimbursable by Medicare-Medicaid. A team identified specific nursing interventions that research supported as decreasing the chance of the patient experiencing a VAP. Interventions included the following:
Elevating the head of bed 30 degrees
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Mouth care every 4 hours
Preintubation respiratory culture
Cuff pressure of the endotracheal tube
Frequent suctioning, using strict sterile technique
A. You are head of the QI team investigating the nurse-sensitive indicators. What are the key performance indicators?
B. What steps are essential to ensure that no further VAPs occur?
C. It is identified that the primary problem contributing to the number of VAPs is that the head of bed is not always elevated to 30 degrees. The benchmark for this indicator is 20%. Of what is this an example?