Long Beach Hospital Eliminates Deadly Ventilator-Associated Pneumonia

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Pacific Hospital of Long Beach was recently recognized for advancing patient safety by eliminating deadly Ventilator-Assisted Pneumonia (VAP). It was one of just eight organizations recognized at CHPSO’s (California Healthcare Patient Safety Organization) Second Annual Conference this April.

Pacific Hospital used a Lean approach to battle VAP. Instances of VAP were kept at zero throughout 2012, hospital-wide. This patient safety success was widely praised at the conference.

Lean management principles have been used in manufacturing companies for decades, originating in Japan and particularly used by Toyota. Lean has been successfully applied to improve the quality of health care in the United States.

VAP occurs in patients who are receiving mechanical ventilation in intensive-care, during medical transport, or elsewhere in the hospital. Bacteria can travel in tiny droplets down the ventilator tube and into the lungs resulting in Pneumonia. This can especially occur in a person who has underlying lung or immune problems. To make matters worse, patients who are mechanically ventilated are often sedated and are rarely able to communicate. Because of this, typical symptoms of Pneumonia may not be present or observable. VAP is a common hospital-acquired pneumonia that occurs in critically ill patients and results in mortality rates as high as 71%. Subglottic secretions (SSs) are a known risk factor. Several clinical trials have shown that continuous aspiration of subglottic secretions (CASS) reduces the risk of VAP by nearly half (1).

In 2006, Pacific Hospital of Long Beach put together a collaborative, multi-disciplinary team to come up with guidelines to combat VAP while ensuring that these guidelines were consistently met in each and every situation. General measures included things as simple as hand washing, aggressive oral hygiene, and patient positioning. Then, more advanced prevention methods such as oral decontamination, regulating endotracheal cuff pressure, and drainage of subglottic secretions were included in the guidelines. By using a simple check list, the team had demonstrated the possibility of bringing the VAP incidence down to zero. And that is exactly what happened in 2012.

Today, the team at Pacific Hospital is focused on doing what it takes to maintain their VAP incidence at zero, training new staff in their lean-centered approach to preventing VAP. This is not the first time Pacific Hospital of Long Beach has been recognized for their new practices and aggressive measures toward patient safety. In 2011, Fox News covered a story entitled “Dr. Clean” which highlighted other successful infection control measures.

References:
1.    Subglottic Secretion Viscosity and Evacuation Efficiency, doi: 10.1177/1099800406295517 Biol Res Nurs January 2007 vol. 8 no. 3 202-209

About Pacific Hospital of Long Beach
Pacific Hospital of Long Beach is a full-service, for-profit, teaching hospital with 184 licensed acute care beds. We are fully accredited and have all the innovative technology that is expected of a medical center while providing a comforting home-like environment.

Source: Pacific Hospital of Long Beach

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Francisco Floressantos
francisco.floressantos@phlb.org
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