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University of Michigan receives national award for eliminating healthcare-associated pneumonia

Second national award for U-M shows it is possible to eliminate healthcare-associated infections

ANN ARBOR, Mich. - At any given time in the United States, 1 in 20 inpatients have an infection associated with health care they have received, and every year about 99,000 people die from a healthcare-associated infection (HAI).

Can HAIs be eliminated altogether? The University of Michigan says yes and will receive a national recognition for its efforts—and results.

On Monday, May 21, two University of Michigan Health System intensive care units—the Surgical Intensive Care Unit (SICU) and Trauma Burn Intensive Care Unit (TBICU)—will receive an outstanding achievement and leadership award for eliminating ventilator-associated pneumonia (VAP). U-M is one of only 12 hospitals and healthcare organizations in the U.S. to receive the award co-sponsored by the U.S. Department of Health and Human Services (USDHHS) and the Critical Care Societies Collaborative (CCSC), which is composed of the American Association of Critical-Care Nurses, American College of Chest Physicians, American Thoracic Society and Society of Critical Care Medicine.

Awardees must have demonstrated success in reducing and eliminating the HAI for 25 months or longer and show national leadership in sharing their evidence-based initiatives to help improve clinical practice. U-M has been successful in its endeavors for more than 9 years.

With U-M’s “best practice” plan of care, treatment and prevention, ventilator-associated pneumonia decreased nearly 10-fold in the SICU and nearly 6-fold in the TBICU.

“We had great success the first year, and we have kept looking for ways to get our rates to the lowest point,” says Chief Medical Officer Darrell “Skip” Campbell Jr.

“In addition to the direct benefit to the patient, reducing the risk of VAP reduces the cost of patient care as well,” Campbell says. “U-M Health System literature shows that the occurrence of a VAP adds at least $50,000 to the total cost of a hospital admission. The successful efforts of the SICU and TBICU thus accomplish the dual goals of health care reform, which are to improve quality while at the same time reducing cost.”

The U-M SICU is a 20-bed ICU that provides care for critically ill surgical patients, including transplant surgery (liver, pancreas, renal), general surgery, emergency surgery and all specialty surgery, and is a Regional Referral Center for care for severe acute respiratory distress syndrome (ARDS) patients that are transferred for possible extracorporeal membrane oxygenation (ECMO). The U-M TBICU is a 10-bed ICU and 6-bed acute care unit that provides care for critically ill adult trauma and burn patients in the U-M Level 1 Trauma Center and ABA verified Burn Center. The TBICU serves as the Michigan Statewide Burn Coordinating Center, responsible for educating and preparing the entire state for advanced burn and trauma care.

The SICU and TBICU participate in the Michigan Hospital Association (MHA) Keystone project to decrease VAP, known as the Keystone ICU VAP Prevention Bundle. The “bundle” is a series of interventions related to ventilated care that, when implemented together, achieve significantly better outcomes than when implemented individually. This bundle includes elevating the head of the patient’s bed, giving patients daily “sedation vacations” while assessing their readiness to have their tube removed, and providing disease prevention for peptic ulcer disease and deep venous thrombosis.

VAP is an airways infection that develops more than 48 hours after the patient was intubated. VAP is the leading cause of death among hospital-acquired infections, exceeding the rate of death due to central line infections, severe sepsis and respiratory tract infections. According to the Institute of Healthcare Improvement, the hospital mortality of ventilated patients who develop VAP is 46 percent compared to 32 percent for ventilated patients who do not develop VAP.

This is the second award for UMHS, which received the 2011 USDHHS/CCSC outstanding leadership award for achievements in eliminating central line-associated bloodstream infections.

HAIs are caused by a wide variety of common and unusual bacteria, fungi and viruses during the course of receiving medical care from traditional hospital settings as well as outpatient surgery centers, long-term facilities, rehabilitation centers and community clinics. A patient is deemed as having an HAI if he or she developed an infection within 48 hours of admission or treatment. Infections can be associated with the treatment the patient received or the devices used in medical procedures, such as catheters or ventilators.

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