Mechanical Ventilation Complication
Conditions
Keywords
Ventilator-associated pneumonia, Mechanical Ventilation, Ventilator-associated events, Intensive care unit, Quality improvement project
Brief summary
This is a pre-post implementation cohort study. This is a data driven quality improvement project which aims to improve the care of mechanically ventilated patients through the implementation of a bundle of evidence based practices, with a goal of reducing ventilator associated events and mortality.
Detailed description
NASAM is a national collaborative quality improvement project in Saudi Arabia which aims to: 1. Reduce the rate of ventilator-associated events 2. Improve the compliance with NASAM bundle elements 3. Reduce the mortality of mechanically ventilated patients The plan of this quality improvement project is to extend the implementation to a total of 100 ICUs in collaboration with multiple health systems across the country. A significant component of this project includes measuring the safety culture of ICUs.
Interventions
OTHEREvidence-based practices
Implementation of evidence-based practices
Sponsors
Ministry of Health, Saudi Arabia
King Abdullah International Medical Research Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
14 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All adult patients admitted to intensive care units
Exclusion criteria
* Age less than 14 years old
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ventilator-associated events | 18 months | Ventilator-associated events rate per 1000 ventilator days in 18 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Head of bed elevation compliance rate | 18 months | The percentage of ventilator days with head of bed elevation ≥30 degrees |
| Spontaneous awakening trial (SAT) compliance rate | 18 months | The percentage of ventilator days with spontaneous awakening trial (SAT) |
| Percentage of ventilated patient days without sedation | 18 months | The percentage of ventilated patient days without sedation use |
| Spontaneous breathing trials (SBT) compliance rate | 18 months | The percentage of ventilator days with spontaneous breathing trial (SBT) |
| Percentage of ventilated patient days without neuromuscular blockers | 18 months | The percentage of ventilated patient days without neuromuscular blockers |
| Sub-glottic endotracheal tube compliance rate | 18 months | The percentage of ventilator days with sub-glottic endotracheal tube use |
| Percentage of CAM-ICU negative (no delirium) | 18 months | The percentage of ventilator days with CAM-ICU negative (no delirium) |
| 90-day mortality | 90 days | The 90-day ICU mortality rate of ventilated patients |
| Mechanical ventilation duration | 90 days | The duration of mechanical ventilation in calendar days |
| ICU length of stay | 90 days | The number of calendar days from ICU admission to discharge from ICU |
| Percentage of out of bed mobility | 18 months | The percentage of ventilated patient days with out of bed mobility |
Countries
Saudi Arabia
Outcome results
None listed