Beyond the Bundle: A Collaborative Strategy to Reduce Ventilator Associated Events

Session Description: Following the initial Coronavirus surge, our acute teaching tertiary hospital system launched a multidisciplinary partnership to reduce Ventilator-Associated Events (VAEs) across seven acute care hospitals. The collaborative team included Infection Preventionists (IPs), Respiratory Therapists (RCPs), and nurses committed to improving intensive care unit (ICU) metrics for our most vulnerable patients. VAEs are associated with increased mortality, prolonged mechanical ventilation (MV), longer ICU and hospital stays, increased healthcare costs and secondary infections.

Standardized processes were instituted for timely identification and mitigation based on Ventilator-Associated Pneumonia (VAP) Bundle best practices to include cross-checks between IPs and RCPs for ventilated patients. This was supported by an electronic medical record (EMR) integrated data tool that enabled daily, consistent, system-wide communication. Educational goals included recognizing VAE types, understanding associated risks, and applying multidisciplinary strategies to manage and mitigate VAEs.

Our surveillance team used a continuous improvement process to standardize workflows and utilized real-time data to improve compliance with the VAP bundle. Key interventions included a secure communication application and a dedicated MV lung protective strategy column in our EMR for immediate identification of patients with acute lung injury. We deployed an array of educational tools: an EMR accordion, MV re-education, badge buddies, and a bedside data collection survey code to reinforce best practices. Our System Critical Care Council drove compliance by reviewing monthly reports to address barriers and reinforced VAP bundle adherence.

This initiative proved highly effective, demonstrating a successful model for data driven, interdisciplinary teamwork to drive VAE reduction. With these changes, our system’s ventilator associated conditions (VACs) decreased by 30.9%, infection-related VACs (IVACs) by 32.1% and possible ventilator associated pneumonias (PVAPs) a significant 76.5%, leading to an overall VAE reduction of 71.31%.

Pamela Moran

Infection Preventionist, Hartford Healthcare

Pamela Moran is an experienced Infection Preventionist at Hartford Hospital, Hartford HealthCare. With over 15 years of expertise in infection prevention, she is dedicated to advancing patient safety and fostering a culture of best practices within the hospital community. Pamela loves collaborating with other departments to strengthen infection prevention strategies and improve outcomes across the continuum of care. She is passionate about education and mentorship, precepting new infection preventionists. Her career began in Microbiology, where she gained a strong foundation in clinical diagnostics. Pamela continues to leverage this laboratory experience, bringing a unique perspective to infection prevention strategies. She holds a Bachelor of Science in Medical Technology from the University of Hartford and is certified as a Medical Technologist (ASCP) and Certified Infection Control Practitioner (CIC) through the Certification Board of Infection Control. Pamela’s commitment to excellence was recognized with the Hartford Hospital Medical Staff Appreciation Award in 2022.

Amy Jodoin

Respiratory System Education Supervisor, Hartford HealthCare

Amy Jodoin is a highly accomplished and recognized Respiratory Therapist with over 15 years of experience in clinical care, education, and informatics. As a key figure at Hartford HealthCare, she holds multiple roles, including System Respiratory Education Supervisor, Clinical Informatics Agent, and Data Analyst for Respiratory Care Innovation & Implementation. She excels at leveraging data-driven insights to improve patient care and operational efficiency, while also developing new programs for staff education, training, and professional development. Her dedication has earned her multiple accolades, including the Proclamation Award for Heroic Action and the John & Louise Julius Award for Outstanding Respiratory Care Practitioner.

Nancy Christy

Manager, Infection Prevention and Control, Baptist Health Louisville

Nancy Christy, MT, MSHA, CIC, is the Manager of Infection Prevention and Control at Baptist Health Louisville in Kentucky. She holds a Bachelor’s degree in Biology from Florida State University and completed her Medical Technology training through the U.S. Navy. Ms. Christy worked in Microbiology for 11 years before transitioning to Infection Prevention, after earning a Master’s degree in Healthcare Administration from Virginia Commonwealth University. She has more than 21 years of experience in Infection Prevention and has been board certified since 2007. Her career has spanned both university-affiliated and community acute care settings. At the national level, Ms. Christy serves as Vice Abstract Chair for the APIC National Conference Committee. She is also an Associate Editor for an APIC textbook and has collaborated with the SHEA Learning CE Committee to develop educational webinars, as well as the Prevention CHKC course.