Decreasing Ventilator Associated Pneumonias (VAP) and Pressure Ulcers (PU): People, Process and Technology

Standard nursing processes were in place to support nursing care excellence, however, in 2007 it was noted that the hospital had seventeen different hospital bed frames and surfaces. It was identified to create a short and long term plan to replace the aging frames and support surfaces while optimizing available capital.  The short term plan was to purchase 220 advanced integrated response surfaces for the high risk units, upgrade the critical care beds to pulmonary LAL surfaces and replace all remaining frames with a static air surface.

Purpose:  The purpose of this analysis is twofold: one to demonstrate improvement in patient outcomes through the use of advanced integrated “therapy on demand” surfaces for skin, pulmonary and mobility support combined with standardized clinical processes; and two, is to demonstrate an overall cost savings to the institution affected by improvements in patient outcomes.

Results:  Improvements were significant in all outcome areas. 

• Facility acquired pressure ulcers were reduced. Quarterly prevalence studies were reduced to 0.9% and 2% for the last two quarters of FY09 and 1.5% for the first quarter of FY10, a consistent year over year improvement.
• There was a steady reduction in VAP with a consistent improvement over the past year including three months with no incidence of VAP.
• Rental spending was decreased by 94.3%.
• Additional benefits included savings of nursing hours.  Both patient and staff satisfaction increased.  

Conclusions:  The investment of advanced bed systems and support surfaces coupled with standardized processes, comprehensive training and commitment to providing quality nursing care improved patient outcomes for AMH while reducing rental costs.  These improvements have been sustained for one year which shows that a combination of people, process and technology provides sustained quality patient care.