CUSP: Improve Teamwork and Communication

Summary

The hospital unit discusses high rates of ventilator-associated pneumonia (VAP) and strategies to reduce it. They agree on the importance of implementing the Ventilator Bundle, which includes elevating the bed's head and daily sedation vacations. The team decides to emphasize the use of the Daily Goals Checklist during rounds to ensure all components are followed, and to keep patients' families informed. This approach is seen as improving communication and patient care, with a positive impact on reducing VAP rates.

Takeaways

• 🏥 The hospital unit is concerned about high infection rates, particularly ventilator-associated pneumonia (VAP).
• 📊 The VAP rate in the unit is higher than the state average for similar ICUs, indicating a need for improvement.
• 🛏️ The Ventilator Bundle is being implemented to prevent infections, including elevating the head of the bed and daily sedation vacations.
• 👀 Observations show that not all components of the Ventilator Bundle are consistently followed in practice.
• 📋 The Daily Goals Checklist is suggested as a tool to improve adherence to the Ventilator Bundle during rounds.
• 🗣️ The importance of communicating the Daily Goals Checklist with patients and their families is emphasized for transparency and engagement.
• 🔄 The team acknowledges the need to reintroduce and prioritize the use of the Daily Goals Checklist in their routine.
• 👨‍👧‍👦 Family members and caregivers are appreciative of the increased information sharing, which also aids the medical team.
• 📈 There is a noticeable improvement in the implementation of daily sedation vacations for patients.
• ⏰ The team agrees on specific times for sedation vacations, such as 2 p.m. for a patient named Mr. Jones.
• 📉 The concerted efforts are expected to lead to a decrease in VAP rates and potentially shorter hospital stays for patients.

Q & A

What is the main concern discussed in the hospital unit regarding infection rates?

The main concern is the high rate of ventilator-associated pneumonia (VAP) in the hospital unit, which is higher than other units and the state average for similar ICUs.

What measures are being implemented to prevent VAP as part of the Ventilator Bundle?

The Ventilator Bundle includes measures such as elevating the head of the bed, daily sedation vacations, and making daily assessments of the patient's readiness for extubation.

Why is it important to follow all components of the Ventilator Bundle?

Following all components of the Ventilator Bundle is crucial for the prevention of infections and improving patient outcomes, as noted by the observation that not all components were being followed initially.

What is the role of the Daily Goals Checklist in improving patient care?

The Daily Goals Checklist helps in regularly reviewing and discussing the components of the Ventilator Bundle during rounds, ensuring that all necessary preventive measures are being taken.

How does the team plan to make the use of the Daily Goals Checklist more effective?

The team plans to reintroduce the checklist and make it a focal part of rounds, discussing it with patients and their families to ensure everyone is on the same page regarding the patient's care.

What was the initial issue with the implementation of the Daily Goals Checklist?

The initial issue was that the checklist was not being used to its full potential, especially during team rounds, and some components of the Ventilator Bundle were not being followed consistently.

How does involving family members and caregivers in the rounds contribute to patient care?

Involving family members and caregivers ensures they are informed about the patient's condition and care plan, which can lead to better compliance and support from the family, as well as early identification of issues like the bed elevation incident.

What is the significance of the sedation vacation for ventilated patients?

Sedation vacation is an important component of the Ventilator Bundle that helps assess the patient's readiness for extubation and reduces the risk of complications associated with prolonged sedation.

How does the team plan to address the issue of not all patients receiving a sedation vacation?

The team plans to ensure that the sedation vacation is scheduled and documented on the Daily Goals Checklist, with specific times agreed upon during rounds, such as at 2 p.m. for Mr. Jones.

What is the expected outcome of using the Daily Goals Checklist more effectively?

The expected outcome is a decrease in the VAP rates and improved patient outcomes, leading to earlier discharges and better overall care.