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St. Joseph's Health Centre Toronto

What is VAP?

VAP is defined as pneumonia (a serious lung infection) that can occur in patients (specifically ICU patients) who need assistance breathing with a mechanical ventilator for at least 48 hours.

What are the signs and symptoms?

The most important symptoms include:

  • Fever
  • Low body temperature
  • New purulent sputum (foul smelling infectious mucous or phlegm coughed up from the lungs or airway into the mouth)
  • Hypoxia (decreasing amounts of oxygen in the blood)

What are the risk factors for VAP?

Risk factors include:

  • Being on a ventilator for more than five days
  • Recent hospitalization (last 90 days)
  • Residence in a nursing home
  • Prior antibiotic use (last 90 days)
  • Dialysis treatment in a clinic

What are health care providers doing to prevent VAP?

Health care providers are:

  • Practicing proper hand washing techniques
  • Keeping the patient’s head of the bed elevated at a 30 to 45 degree angle
  • Discontinuing mechanical ventilation as soon as possible
  • Using a special breathing tube that reduces secretions falling down into the lungs
  • Using the smallest possible feeding tube through the nose

Preventing VAP : What families of patients can so

Families of patients can:

  • Ask lots of questions. Ask what precautions your hospital is taking to prevent VAP.
  • Wash their hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.

How is VAP treated?

Since VAP is caused by bacteria in the lungs, it is treated by using antibiotics.

St. Joseph's Public Reporting

What is being publicly reported?

The Ministry will publicly report and post on its website by hospital site:

  • The number of VAP cases. Where the number is zero (0) or cases total five (5) or more associated with that hospital site, the number will be posted. If the cases are fewer than 5 (i.e., 1 to 4 cases), it will state “<5 cases”, and
  • The VAP rate (per 1000 ventilator days).

What determines the rate?

The VAP rate is determined by the total number of newly diagnosed VAP cases in the ICU after at least 48 hours of mechanical ventilation, divided by the number of ventilator days in that month, multiplied by 1,000. Ventilator days are the number of days spent on a ventilator for all patients in the ICU 18 years and older.

What is the health care system doing with this information?

Hospital VAP rates provide one measure of patient safety and quality of care.

The information gathered will assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.

Please see VAP Rates for more information.

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