Critical Care: Preventing Ventilator-Associated Pneumonia

Question 1

What organization has developed a ventilator bundle?

Answer 1

Institute for Healthcare Improvement

Question 2

What outcome does the ventilator bundle target?

Answer 2

Ventilator-associated pneumonia and complications arising from it

Question 3

List five elements of the ventilator bundle

Answer 3

1. Head of the bed elevation
2. Daily sedation interruptions and assessment of readiness to extubate
3. Stress ulcer prophylaxis
4. VTE prophylaxis
5. Daily oral care

Question 4

To what degree should the head of the bed be elevated in a ventilated patient?

Answer 4

30-45 degrees

Question 5

With what should daily oral care be performed?

Answer 5

Chlorhexidine 0.12% oral rinse

Question 6

List two additional methods of preventing ventilator-associated pneumonia

Answer 6

1. Selective decontamination of the digestive tract

2. Silver-coated endotracheal tubes

Question 7

Describe selective decontamination of the digestive tract (2 components)

Answer 7

1. Short course of ABX aimed at eradicating potential pathogens to minimize ICU-acquired infections.
2. Selective decontamination is still not routinely performed.

Question 8

Describe silver-coated endotracheal tubes (2 components)

Answer 8

1. Silver coating reduces infection

2. Often cost-prohibitive