Medical Devices Pose Big Infection Threat

VAP is largely preventable. Researchers from the Institute for Healthcare Improvement (IHI) — a non-profit organization that strives for healthcare improvement throughout the world — VAP prevention components should be bundled. Important tenets include:

Proper angling of bed elevation

Daily sedation vacations and assessment of readiness to extubate

Peptic ulcer disease prophylaxis

Deep venous thrombosis prophylaxis⁵

There are several precautionary steps that healthcare workers can take to help prevent VAP, says David Park, general manager of North America Medical Devices for Kimberly-Clark Health Care.

“One step that is often overlooked due to the hectic environment of the ICU is the patient’s oral hygiene,” Park says. “One of the key steps to help decrease the microbial load in the oropharyngeal cavity of the patient’s mouth is by providing consistent and comprehensive oral care to ventilated patients. Because ICU nurses are so busy and have limited amounts of time to spend with each patient, it is important to choose an oral care system specifically designed for convenience and ease-of-use by caregivers.”

Park suggests that oral care systems be equipped with all the proper oral hygiene items that are essential to comprehensive oral care protocols.

“Use an oral health assessment form to determine the state of the patient’s oral health and oral care needs on a daily basis,” he says. “This will help identify if the patient has developed any abnormalities or mucositis, an oral tissue inflammation, which can increase the risk of VAP.”

The human body doesn’t always fend off infection, but at least it has a chance. Medical devices, however, have no defense mechanisms and must therefore be kept clean before and while they’re being used. Any nearby entry site must also be properly cared for. This has always been important, but come Oct. 1, the consequences will increase.

References:

1. Institute for Healthcare Improvement: Getting Started Kit: Prevent Central Line Infections, How-to Guide. www.ihi.org/ihi.

2. Salgado CD, et al. Increased rate of catheter-related bloodstream infection associated with use of a needleless mechanical valve device at a long-term acute care hospital. Infection Control and Hospital Epidemiology. 2007;28.

3. Rupp ME, et al. Outbreak of bloodstream infection temporally associated with the use of an intravascular needleless valve. Clinical Infectious Diseases. 2007;44.

4. Evans B. Best-practice protocols: VAP prevention. December 2005, Volume 36.

5. VHA Inc. Web site: http://www.vha.com/.