Ventilator-Associated Pneumonia

Ventilator-associated pneumonia (VAP) occurs when germs multiply in the lungs of patients using a ventilator to help them breathe. This causes fevers, chills, difficulty breathing, increased sputum and other pneumonia symptoms.

These infections can lead to serious complications, even death, especially for critically ill patients.

What is a ventilator?

A ventilator is a life-saving machine that helps people breathe when they cannot breathe well on their own. Often, patients are connected to a ventilator in surgery or when recovering from serious illness. A ventilator is connected to a tube — called an endotracheal or "ET" tube — placed in the patient's lungs. The tube is inserted through the mouth, nose or throat.

At UCSF Benioff Children's Hospital San Francisco, patients connected to a ventilator are always in an intensive care unit or in surgery. A ventilator may be left in place for several weeks.

How does UCSF Benioff Children's Hospital San Francisco monitor VAP rates?

UCSF Benioff Children's Hospital San Francisco measures VAP rates according to the methods of the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention. Rates are expressed as the number of infections per 1,000 ventilator days, or the total number of days patients use a ventilator. For example, if a patient is on a mechanical ventilator for five days, that would count as five ventilator days.

What is the VAP rate at UCSF Benioff Children's Hospital San Francisco?

Lower is better when comparing VAP rates. Individual units compare against NHSN data.

UCSF Benioff Children's Hospital San Francisco achieved a VAP rate of 0.53 VAP/1,000 ventilator days in fiscal year 2017.

Our goal is to have zero cases of ventilator-associated pneumonia in our hospital.

What does UCSF Benioff Children's Hospital San Francisco do to prevent VAP?

To prevent ventilator-associated pneumonia, we:

• Keep the head of the bed elevated to 30 degrees or higher to prevent stomach acids from entering the lungs.
• Clean the patient’s mouth at least six times each day to reduce the risk of mouth germs getting into the lungs.
• Clean our hands before touching patients and ventilators.
• Remove the ventilator and tube as soon as patients can safely breathe on their own.
• Clean the ventilator at least twice each day.
• Give medications to keep the patient comfortable and at the least risk for getting VAP.
• Audit the procedures to confirm our employees follow procedures properly.
• Have a committee of Infection Control staff, nurses and doctors that meets frequently to review our VAP rates and examine the care we give. If a VAP occurs, this committee evaluates what, if anything, went wrong,

What can parents do?

Talk to your child's health care team members. Find out when the ventilator can be safely removed. If you don't see a doctor, nurse or technician clean his or her hands, ask him or her to do so before touching you, your child or the ventilator.