Bay Regional Medical Center
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Bay Regional Medical Center (BRMC) is a strategic partner with the Institute for Health care Improvement (IHI) in an 18-month nationwide campaign that has saved an estimated 122,342 lives.
Bay Regional recently completed 14th consecutive month with no ventilator associated pneumonia. The IHI did not provide an estimate of the number of lives saved at BRMC.
Besides saving lives, hospitals enrolled in the program have begun new standards of care that will continue to save lives and improve health outcomes in the future, according to Dr. Donald Berwick, president of IHI.
According to the American Nurses Association (ANA) this breakthrough campaign provides a unique opportunity for nurses to make an impact in effecting positive change in patient safety/advocacy at individual hospitals and across the nation.
Dr. Rita Munley Gallagher, PhD, RN, C, formerly of Bay City, senior policy fellow of the ANA, assisted the president of the organization in supporting the IHI program.
Hospitals and nursing staff were involved in the campaign which consists of evidence-based interventions to improve quality and patient safety. Hospitals implemented any or all of the programs, including:
· Deployment of Rapid Response Teams (that include nurses)
· Delivery of Reliable, Evidence-Based Care for Acute Myocardial Infarction
· Prevention of Adverse Drug Events (ADEs)
· Prevention of Central Line Infections
· Prevention of Surgical Site Infections
· Prevention of Ventilator-Associated Pneumonia
Over 3,000 hospitals, representing an estimated 75 percent of U.. hospital beds, throughout all 50 states and the District of Columbia were involved in this program.
The BRMC involvement is detailed as follows by the IHI:
Prevent Ventilator-Associated Pneumonia
Bay Regional Medical Center, Bay City, MI
Availability Status: Available to answer requests
Licensed Beds: 415
Teaching / Non-Teaching Status: Teaching
Urban / Rural Status: Urban
Start Date of Intervention Work: March 2004
Mentor Contact Name: Sue Lathrom
Mentor Contact Email: sue.lathrom@bhsnet.org
Mentor Contact Phone: 989-894-3008
Additional Information:
Goal: Eliminate or reduce ventilator associated pneumonia, duration of mechanical ventilation and ICU length of stay.
Implementation:
1) Developed a dedicated team including Senior administration
2) Provided evidence based education to all critical care, respiratory and medical staff.
3) Developed ventilator standing orders and integrated clinical pathway.
4) Developed daily rounding form to collect data and utilized as a compliance tool.
5) Rounded every AM on ventilator patients that were ventilated> 24 hours.
6) Monthly review of data including action plans to improve outcomes
7) Reported monthly results to various committees throughout organization and posted results for staff to evaluate.
We ask staff to implement the following standing vent orders:
1) Elevate the head of bed
2) Provide peptic ulcer and venous thrombosis prophylaxis
3) Appropriately sedate ventilated patients/shift evaluation of mental status
4) Test daily if patients can be extubated.
5) Use continuous subglottic suctioning/oral care
6) Implement standing orders for blood glucose levels > 150 (Portland protocol)###
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