title: Implementing a ventilator care bundle in an adult intensive care unit.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP), in addition to causing distress to patients, is associated with increased length of stay in intensive care, higher rates of morbidity and mortality and pressure on critical care capacity and costs. A care bundle approach for the management of ventilated patients can reduce the risk of VAP.
  
  
  OBJECTIVE
  This paper aims to appraise the implementation of a series of high impact intervention care bundle components directed at preventing the development of VAP, within an adult intensive care unit of a district general hospital.
  
  
  METHODS
  Subsequent to the implementation of care bundle components, evidence from audit data revealed that compliance fell below standard. To address this, Department of Health staff who were visiting the hospital recommended that the frequency of audit activity should be increased to facilitate the rapid identification of areas of poor compliance, which could then be rectified.
  
  
  CONCLUSIONS
  Daily care bundle audits showed a positive impact on compliance. However, without a robust method to collect data on prevalence of VAP, the impact of the care bundles on improving outcomes for this aspect of care is unknown.
authors.affiliation: Intensive Care Unit, Royal Bolton Hospital, Bolton, UK. samantha.westwell@rbh.nhs.uk
authors.forename: Samantha
authors.initials: S
authors.lastname: Westwell
mesh_terms: D000328:Adult; D003422:Critical Care / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003625:Data Collection; D004739:England; D004866:Equipment Contamination / Q000517:prevention & control; D019317:Evidence-Based Medicine; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D009910:Oral Hygiene / Q000451:nursing; D017063:Outcome Assessment, Health Care; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011187:Posture; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing; D012307:Risk Factors; D013276:Stomach Ulcer / Q000517:prevention & control; D013396:Suction / Q000451:nursing; D020246:Venous Thrombosis / Q000517:prevention & control