Critical care bug team: a multidisciplinary team approach to reducing ventilator-associated pneumonia.
BACKGROUND
Ventilator-associated pneumonia rates in the medical-surgical intensive care unit first exceeded the 90th percentile in September 1997 and were significantly (P <.05) higher than National Nosocomial Infections Surveillance System pooled mean data. In January 1998, a multidisciplinary "Critical Care Bug Team" was developed by the Infection Control Committee to review 1997 National Nosocomial Infections Surveillance System data for four adult intensive care units in a 583-bed tertiary care hospital.


METHODS
Membership included clinical nurse specialists, a dietitian, a pharmacist, a respiratory therapist, an infection control professional, a research specialist, and a physician adviser. Having the team report directly to the hospital's Infection Control and Adult Critical Care Committees maximized support for recommendations and provided a direct link from patient care to hospital administration. By identifying issues, evaluating patient care processes, performing literature searches, and monitoring compliance, the team implemented numerous interventions, including policy and procedure changes, purchasing of equipment, and implementation of various education tools.


RESULTS
Each member of the Critical Care Bug Team contributed to a synergized effort that may have produced the desired outcome of decreasing ventilator-associated pneumonia rates. Except for August 1998, ventilator-associated pneumonia rates have been below the 75th percentile since May 1998.


CONCLUSIONS
This study illustrates the effectiveness of a multidisciplinary team approach devised to reduce and stabilize ventilator-associated pneumonia rates in a medical-surgical intensive care unit.
Kaye
J
J
University Hospital, Patient Care Administration, Augusta, GA 30901-2629, USA.
Ashline
V
V
Erickson
D
D
Zeiler
K
K
Gavigan
D
D
Gannon
L
L
Wynne
P
P
Cooper
J
J
Kittle
W
W
Sharma
K
K
Morton
J
J
D000328:Adult; D003422:Critical Care / Q000458:organization & administration*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D005845:Georgia; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007362:Intensive Care Units; D009936:Organizational Innovation; D016134:Organizational Policy; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000193:education; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D011159:Population Surveillance; D016730:Program Development; D015397:Program Evaluation; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors