Improving management of ventilator associated tracheitis in a level IV NICU.

Ellen C Ingolfsland, Juan David Gonzalez-Villamizar, Jeanne Moore, Janet Kubly, Hawa M Ali, Ann Kvant, Betsy Smith, Laura Norton

Journal of perinatology : official journal of the California Perinatal Association 2022 Sep

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There are no published guidelines regarding the diagnosis and treatment of ventilator-associated tracheitis (VAT) in the neonatal intensive care unit (NICU). VAT is likely over-diagnosed and over-treated, increasing antibiotic burden and cost. Diagnosis and treatment of VAT were entirely NICU provider dependent. Retrospective pre- and post-intervention chart reviews were performed. A VAT diagnosis and treatment algorithm was created for use in the care of intubated patients without tracheostomies. 3 plan-do-study-act (PDSA) cycles were used to implement change. Intubated patients treated for VAT with <25 PMNs on Gram stain decreased from 79% to 35% following the quality improvement (QI) initiative. Treatment of VAT with >7 days of antibiotic therapy decreased from 42% to 10%. Implementing a QI initiative to improve the diagnosis and treatment of VAT in the NICU decreased the percent of patients treated inappropriately for VAT. © 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.

Citation

Ellen C Ingolfsland, Juan David Gonzalez-Villamizar, Jeanne Moore, Janet Kubly, Hawa M Ali, Ann Kvant, Betsy Smith, Laura Norton. Improving management of ventilator associated tracheitis in a level IV NICU. Journal of perinatology : official journal of the California Perinatal Association. 2022 Sep;42(9):1260-1265