360 / Ventilator-associated pneumonia prevention program in the ICU

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Pneumonia prevention
There is no specified text here There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
The "Neumonia zero" Spanish project was born after the successful "Bacteriemia zero" project in the Spanish intensive care units (ICUs). The same group of experts from SEMICYUC (Sociedad Espanola de Medicina Intensiva,Crítica y Unidades Coronarias - a Spanish scientific society) disseminated the core document for the Neumonia zero project titled: “Recommendations for the VAP prevention in Spanish ICUs”. The main objective was to reduce the mean national incidence_density_rate_(ID) of ventilator_associated_pneumonia-(VAP) to <9 episodes per 1000 days of mechanical ventilation (MV).The secondary objective was to increase the patient safety culture in the Spanish ICUs.
There were over a hundred participants (Spanish ICUs) and the expected outcomes were obtained. Our regional hospital ICU obtained very good outcomes. The VAP-ID was reduced to 5,07 episodes per 1000 days MV in 2011 and to 1,72 episodes in 2012. Before Neumonia zero project the rates had been 10,91 episodes for 1000 days MV in 2010 and 11,15 episodes for 1000 days MV in 2009. The use-ratio of artificial airway was 0.55. We introduced the tracheal tube with SSA (subglottic secretions aspiration). Furthermore the Neumonia zero project improved the patient safety of those who received artificial respiratory support in our ICU. A specific sheet was introduced for the patient undergoing artificial airway (even not invasive ventilation) to fill in each nurses shift.
Our study was communicated in the XXXIIII Reunió de la SOCMIC (Societat Catalana de Medicina intensiva i Crítica),on March 7,2013,Barcelona.(not published) (N.78-“Pneumonia zero en una unitat de medicina intensiva comarcal.Estudi de 18 mesos”)
Description of the Patient Safety Practice
 
Method: The intervention to prevent VAP consist in two complementary activities with the similar importance to achieve in the ICU: 1) STOP-VAP ,and 2) PSI (Integral Safety Patient).
Implementation: 1)STOP-VAP: the application the bundless with ten procedures,whose are obligatory basic(7 procedures) and optionally specific with high recommendation(3 procedures).
2)PSI: consist in to evaluate the safety culture (basal and periodic) in your ICU; formation in safety patient;to identificate the error in the clinic practice for to learn of them;to establish alliance with the board of directors institution,and to increase the professionals comunication through the sheet of daily objectives.
Evaluation:1)control VAP episodes number;days in mechanical ventilation; control incidence density of VAP(episodes VAP/ 1000days mechanical ventilation).2)Evaluation formation: on line examination,and diploma.3)Pursuit adherence to the project Neumonia zero: web register the information about ICU nosocomial infections, specially PAV.4)Climate safety in the ICU: Evaluation Hospital Survey on Patient Safety Culture.
Attachment of relevant written information and/or photos, as appropriate
398_WP4_evaluación-del-cumplimiento-de-las-medidas-de-nz.docx
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
in press.
- Document of the MSPSI(Ministerio de Sanidad,Politica Social e Igualdad)-Seguridad de pacientes
-group GTEI-SEMICYUC(Grupo Trabajo Enfermedades Infecciosas-Sociedad Espanola de Medicina intensiva,Crítica y Unidades Coronarias).http://www.semicyuc.org
- Document of the Generalitat de Catalunya-Departament de Salut.http://www20.gencat.cat/portal/site/canalsalut/
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
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Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Not known
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of incentive
No management support
Publicity and/or marketing of the solution
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Not relevant
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Montserrat Casanovas Taltavull
Country: SPAIN
Organisation: Hospital d'Igualada, Catalonia
E-mail: mcasanovast@gmail.com
Phone: 938075571
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