Table 13 'Ventilator Pneumonia'

PSI 12: Ventilator Pneumonia
Origin: Review of a OECD PSI (33)
Dimension Description
Description of Specific
Aspects of Patient Safety
Ventilator-associated pneumonia (VAP) is a leading cause of morbidity
and mortality in the Intensive Care Unit (ICU). Incidence of VAP
varies greatly, ranging from 6-52% of intubated patients depending on
patient risk factors. Overall VAP is associated with an attributable
mortality of up to 30%. Given the consequences of VAP, VAP rates
appear to be a suitable patient safety measure (33).
Aim of the PSI This PSI is intended to flag cases of ventilated inpatients developing
pneumonia.
Level of Determination of
Patient Safety
Safety is assessed at the aggregated patient level.
Source(s) The Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) Indicator Measurement System: Infection Control (39).
Similar national organisations, responding to the same issue are
Australian Incident Monitoring System and the National Patient Safety
Agency in the UK (33).
Extent of Clinically
Testing
The OECD Health Care Quality Indicators (HCQI) Project was
initiated to implement quality measures for international
benchmarking of medical care at the health system level. Five priority
areas including patient safety were selected. International expert
panels were formed to identify clinically important, scientifically
sound, and feasible measures based on a structured consensus process.
The consensus process was successfully completed in all five priority
areas leading to a recommendation of 86 indicators of which 21 cover
patient safety (33).
The results suggest that this PSI may be useful as a measure of patient
safety (33).
Evidence of Clinically use
of Standards
No evidence of clinically use of standards was found.
PSI category Theme Related PSI: “Infection Control”.
Data definitions
Numerator Description Number of ventilated inpatients developing pneumonia.
Denominator Description Number of inpatient (ICU and Non-ICU) ventilator days.
Data Source Administrative data.
Identifying the
institutional context
The impact of pneumonia makes this PSI important for both financial
and quality improvement policies.
SImPatIE WP4 – Catalogue of Patients Safety Indicators
35
Care Setting The PSI applies for high quality intensive nursing care.
Professionals Responsible
for Health Care
Nurses.
Lowest Level of Health
Care Delivery Addressed
Individual clinical department.
Allowance for Patient
Factors
No risk adjustment described.
Stratification by
Vulnerable Populations
No stratification.
Standard of Comparison No specific standards given.
Scoring No specific scoring standards given.