APIC 2019 (Riffat)
APIC 2019 (Riffat)
1. Learners will be able to identify actual issues in their system when they
Problem Statement
In the month of August 2017 at Tertiary Care Hospital, HAI surveillance
system was modified to see that how many patients received hospital
acquired pneumonia from ventilator and it was identified that 61.2 cases
per 1000 ventilated days got VAP which was a leading cause to increase a
patient’s stay with ventilator that was almost 8 days.
Several standards of care have been developed in attempt to reduce the
occurrence of VAP rate and patient stay with ventilator
PURPOSE
2. 50% reduction of hospital acquired VAP rate and patient stay with
ventilator from 8 to 5 by the end of December 2017.
Start
SWIM LANE MAP End
Doctor Yes
Daily Peptic ulcer Deep vein
sedation diseases thrombosis
interruption prophylaxis prophylaxis
NO Extubate
Oral Care +- Use of filter Suctioning with
with normal without describe no decribe
Nurse MW time frame method
Control Measures
Control Measures
5. SC will not dip 100% Daily round Daily TL Training, observation and
in whole N/S report compliance monitoring
8. Resource 80% Check the PAR Monthly TL & Observation and compliance
Management level and Items HOD monitoring and corrective
request sheet of action
unit
METHODOLOGY :Control Measures
End
Start
(Improved) SWIM LANE MAP
Healthy patient
Patient Need MV (Can breath)
Numerator 15 8 7 3 8
70.0
VAP Rate
61.2
60.0 57.1
50.0
40.2
40.0
VAP
30.0 24.0 Rate
20.0 16.0
10.0
0.0
Aug Sept Oct Nov Dec
RESULT: Data of Patient’s stay
with ventilator
StayStay
#
G1 G2
1 6.5 3.5
2 6.5 4.8
3 7.5 3.6
4 6.0 4.6
5 6.9 5.0
6 7.18 3.9
7 7.11 3.7
8 5.9 4.2
9 5.7 4.3
10 6.2 3.4
11 6.44.18
12 8.04.21
13 5.5 4.00
14 5.2 3.7
15 5.14 3.2
CONCLUSION
Details Category
Initially, implementation of surveillance system
IPC team
with modification was very tough