IADR Abstract Archives
Preventing Pneumonia in Ventilator Dependent Patients through Oral Care
Objectives: Background: Ventilator-associated pneumonia (VAP) is a lung infection that develops in a patient on a ventilator. VAP has a high rate of morbidity and mortality. Oral care is part of the Institute for Healthcare Improvement (IHI) ICU care bundle and is recognized as an important intervention to reduce VAP in inpatient settings. Patients using ventilators at home are similarly at risk for pneumonia, but are without a similar intervention.
Objective: Assess the impact of a new home-care bundle (“HOMEAIR”) to prevent Pneumonia in ventilated patients at home.
Methods: A quality improvement record review of home ventilator dependent patients was performed to evaluate the effectiveness of the HOMEAIR bundle. The HOMEAIR bundle was developed by an interdisciplinary team including dental and medical providers at the Complex Care Center, University of Rochester, by modifying the IHI-ICU care bundle for the home setting. The bundle was broadly distributed to primary care and ICU doctors, dentists, ventilator vendors and patients in Greater Rochester NY.
Results: Episodes of pneumonia in ventilated patients were identified by cross referencing diagnosis codes for pneumonia with diagnosis codes for the home ventilator dependence the year before and two years following the intervention. Rates were compared pre- and post-HOMEAIR education intervention. Inpatient admissions reduced by 30% and Emergency Department (ED) utilization fell by 23%.
Conclusions: There was a downward trend in hospital admissions and ED visits for pneumonia in home ventilated patients after HOMEAIR education was provided. The data suggests that delivery of the multipronged HOMEAIR bundle, including oral care, can reduce the incidence of pneumonia in home ventilated patients. While more research is needed, results indicate that HOMEAIR is an effective method to reduce pneumonia in ventilated patients. Oral healthcare is a key element in the HOMEAIR bundle because it decreases the presence of causative bacteria of pneumonia.
Objective: Assess the impact of a new home-care bundle (“HOMEAIR”) to prevent Pneumonia in ventilated patients at home.
Methods: A quality improvement record review of home ventilator dependent patients was performed to evaluate the effectiveness of the HOMEAIR bundle. The HOMEAIR bundle was developed by an interdisciplinary team including dental and medical providers at the Complex Care Center, University of Rochester, by modifying the IHI-ICU care bundle for the home setting. The bundle was broadly distributed to primary care and ICU doctors, dentists, ventilator vendors and patients in Greater Rochester NY.
Results: Episodes of pneumonia in ventilated patients were identified by cross referencing diagnosis codes for pneumonia with diagnosis codes for the home ventilator dependence the year before and two years following the intervention. Rates were compared pre- and post-HOMEAIR education intervention. Inpatient admissions reduced by 30% and Emergency Department (ED) utilization fell by 23%.
Conclusions: There was a downward trend in hospital admissions and ED visits for pneumonia in home ventilated patients after HOMEAIR education was provided. The data suggests that delivery of the multipronged HOMEAIR bundle, including oral care, can reduce the incidence of pneumonia in home ventilated patients. While more research is needed, results indicate that HOMEAIR is an effective method to reduce pneumonia in ventilated patients. Oral healthcare is a key element in the HOMEAIR bundle because it decreases the presence of causative bacteria of pneumonia.
