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Fortis Hospital, Noida has achieved a VAP rate of zero per cent.

Elaborates Dr Ashok V Chordiya, Director, Fortis Hospital Noida, "Between June 2008 to November 2008 it was (Mean + Standard deviation) 89.45 +3.27/1,000 ventilator days. After focused intervention from December 2008 to March 2009, it decreased to 23.62 + 9.64/1000 ventilator days from April 2009 to September 2009."

Elaborating the need for a low VAP rate, Dr Mrinal Sircar, HOD- Critical Care and Pulmonology, Fortis Hospital Noida, elaborates, "VAP is associated with 33 to 50 per cent attributable deaths anywhere in the world with best treatment. Also, VAP means longer stay in ICU and hospital, greater cost of treatment and also other organ failure." He adds that it is important to maintain lower VAP rates to increase the patient outcome as well as decrease cost of care. This in turn ensures better utilisation of ICU beds.

To combat VAP, various strategies were employed. Education of nurses was used as the key tool. Critical care team along with nursing team extensively taught the ICU nurse about infection control measures from December 2008 to March 2009. This was followed up with bi-monthly short sessions to ensure coverage of new joinees. Elaborates Dr Mrinal Sircar, HOD- Critical Care and Pulmonology, Fortis Hospital, Noida, "We laid great emphasis on hand washing (using alcohol rub) and improved oral care practices. One nurse was deputed during daytime shifts to walk around the ICU encouraging all doctors, nurse, other healthcare workers and relatives visiting the ICU patients to use alcohol rub before and after coming in contact with the patient and their immediate surroundings." Also written 'Infection Control Bundles' were provided at each bedside in the ICU as a ready reminder.

Dr Chordiya adds, "From April 2009 to September 2009 VAP rates were zero for five out of six months, including continuous period from June - September 2009. Challenge now lies in maintaining the zero rate." .

Sonal Vij