Page 41 - Demo

Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-15Effectively Reducing Incidence of Ventilator-Associated Pneumonia (VAP) in theIntensive Care Unit (ICU) of Sunway Medical CentreNaadhiya SK, Fong WK, Caroline E, Sharon AS, Vivian FSunway Medical CentreSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Ventilator-Associated Pneumonia (VAP) poses a substantial threat to critically ill patients as it leads tohigher mortality rates. Verification study showed that the incidence of VAP in ICU increased by 15%within one month from February to March 2022. The study aims to effectively reduce the incidence ofVAP in ICU.KEY MEASURES FOR IMPROVEMENT:The key indicator for improvement was measured using the incidence rate of VAP in ICU. The standardwas set as <5% based on consensus during the Infection Prevention and Control Meeting at SunwayMedical Centre.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted in ICU from June 2022 to August 2023 in two consecutivephases. Sampling population included ICU nurses, doctors and cleaners. Data to identify contributingfactors was collected through direct observational audits of compliancy towards workflow processesusing e-forms and apps.ANALYSIS AND INTERPRETATION:Pre-remedial study showed the incidence in VAP cases in ICU was 15.75% and the contributing factorswere mainly poor compliancy to hand hygiene (0%), ventilator care (30%), feeding set and nebuliser setcleaning and storage practices (0%), ventilator cleaning (20%) and environmental cleaning (67%).STRATEGIES FOR CHANGE:The implemented strategies included re-emphasising hand hygiene and ventilator care bundle practicesamong ICU staff and using dedicated closed containers for feeding equipment storage. In cycle 2,additional strategies were introduced such as enhancing cleaning for ventilators and environment, andusing dedicated nebuliser set storage containers.EFFECT OF CHANGE:In cycle 1, staff compliancy increased towards hand hygiene (96%), ventilator care bundle practices(98%) and feeding preparation and storage (100%). In cycle 2, compliancy increased for nebulisationpreparation and storage (100%), ventilator cleaning (93%) and environment cleaning (96%). Wesuccessfully reduced the incidence of VAP to 0% in the ICU.THE NEXT STEP:We aim to publish this experience as a full research article in the near future.40 | Page