Linda L Horton RN MSN CPHQ Mercy Hospital
- Slides: 8
Linda L. Horton, RN, MSN, CPHQ Mercy Hospital Buffalo January 18, 2012
About Us Team Composition • Mercy Hospital Buffalo, New York 350 bed tertiary care Regional transfer center 2 ─ David Durante, MD Director Critical Care ─ Jarrod Atkinson, RN Nurse Manager ICU ─ Staff nurses ─ Respiratory Therapy ─ Pharmacy ─ Physical Therapy ─ Infection Control ─ Hospitalist ─ Nurse Practitioner ─ Radiology
Background VAP bundle got us started and progress was made relative to outcomes, but Vent days and use of propofol still exceeded project targets.
Changes Made • • Actions Taken physician leader rounding daily ** education to associates on MAAS scores ** daily sedation vacations scheduled by the nurse caring for the patient ** Mobility, dangle, OOB ** support from interdisciplinary team ** ─ pharmacy, respiratory therapy, nurses, physicians, physical therapy VAP bundle re-education ─ use of ventilator order sheet ─ HOB elevation – 300 ─ Implementation of oral care policy & q 4 h oral care kits • • • protocol driven sedation tools for propofol (sedation) use communication streamline documentation
Results Started ICU Expedition
Lessons, Challenges and Next Steps • • Beyond the Bundle Pain Management versus Sedation Staff champions support Leadership support and visibility with the staff in the unit. Keeping in touch with the front line staff • Case review of events like a root cause lessons learned, barriers, “old habits” • Daily rounds at the bedside
Favorite tools/resource to share • CDC Ventilator Associate Pneumonia • IHI Ventilator Bundle • APIC Ventilator Pneumonia Prevention
Questions? Linda L. Horton lhorton@chsbuffalo. org 716 -828 -2066
