Medline Industries, Inc., a privately held manufacturer and distributor of healthcare supplies, today launched an evidence-based solution to help prevent ventilator-associated pneumonia (VAP). The system features chlorhexidine gluconate (CHG) oral rinse, educational packaging and comprehensive clinical education. According to the National Healthcare Safety Network, VAP is the second most common healthcare-acquired infection (HAI) and is associated with substantial morbidity and mortality.(1)
Medline's VAPrevent system features a cutting-edge dispensing system that contains individual procedure kits for performing oral care on ventilated patients. The system is designed to help clinicians dispense the kits one-at-a-time and in the right order. Each kit is easily identifiable (set-up kit, suction toothbrush and catheter kit, suction swab kit) and labeled with the time to use it, helping ensure the treatments are on schedule to drive compliance.
"The kit is intuitive to use because it makes it very easy for the clinician to know which component to use and the appropriate time to use it," says Connie Steed, director of infection prevention and control at Greenville Hospital System University Medical Center in Greenville, S.C. "Including CHG in the kit is also extremely important for providing effective daily oral care to ventilated patients, and it is clinically proven to reduce the risk of VAP."
VAP can occur in people who are on mechanical ventilation through an endotracheal or tracheostomy tube for at least 48 hours. A major cause of VAP is oral bacteria that thrive in dental plaque and oropharyngeal secretions making their way into the lungs by way of a mechanical ventilator.
Overall, VAP occurs in up to 25 percent of all people who require mechanical ventilation, and according to the CDC, is the leading cause of death among hospital acquired infections with a mortality rate of 20 percent to 33 percent.(2) Each incidence of VAP is estimated to generate an increased cost of $20,000 to $40,000.(2)
Preventing VAP involves limiting exposure to bacteria, discontinuing mechanical ventilation as soon as possible and a variety of strategies to limit infection while intubated. In May, the Institute for Healthcare Improvement (IHI) added CHG to their "ventilator bundle" as an oral rinse to be used twice daily.(3) CHG is an inhibitor of dental plaque formation and gingivitis and is proven to lower the risk of VAP.
In addition to CHG, the VAPrevent system also offers clinicians the choice of hydrogen peroxide or the alcohol-free, moisturizing Biotene® as options for effective daily oral care. Color-coded packaging helps caregivers quickly identify the different types of oral care options, provides the caregiver with education and helps drive compliance.
"The VAPrevent oral care system uses innovative packaging design to address clinical concerns such as consistent and timely performance of oral care," says Alecia Cooper, senior vice president of clinical services for Medline. "The packaging makes it easy for the clinician to do the right thing by dispensing the kits one at a time and in the right order. Combined with comprehensive education, the new program, which emphasizes the IHI's ventilator bundle, will help facilities prepare to significantly reduce the chance for infection."
The VAPrevent program includes comprehensive education and training for caregivers, patients and families. The caregiver education -- all provided online through Medline University -- includes three separate modules, an interactive competency test and brief courses on different aspects of proper oral care -- providing clinicians a quick bedside review of the steps and techniques.
1. http://www.cdc.gov/nhsn/PDFs/slides/VAP-DA_gcm.pdf, page 8.
2. CDC. Guidelines for Preventing Healthcare-Associated Pneumonia, 2003. Recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR 2004; 53 (No. RR-3).