Critical care bug team: A multidisciplinary team approach to reducing ventilator-associated pneumonia

Background: Ventilator-associated pneumonia rates in me medical-surgical in tensive care unit first exceeded the 90th percentile in September 1997 and were significantly (P < .05) higher than National Nosocomial Infections Sur veillance System pooled mean data. In January 1998, a multidisciplinary "Cr itical Care Bug Team" was developed by the Infection Control Committee to r eview 1997 National Nosocomial Infections Surveillance System data for four adult intensive care units in a 583-bed tertiary care hospital. Methods: Membership included clinical nurse specialists, a dietitian, a pha rmacist, a respiratory therapist, an infection control professional, a rese arch specialist, and a physician adviser. Having the team report directly t o the hospital's Infection Control and Adult Critical Care Committees maxim ized support for recommendations and provided a direct link from patient ca re to hospital administration. By identifying issues, evaluating patient ca re processes, performing literature searches, and monitoring compliance, th e team implemented numerous interventions, including policy and procedure c hanges, purchasing of equipment, and implementation of various education to ols. Results: Each member of the Critical Care Bug Team contributed to a synergi zed effort that may have produced the desired outcome of decreasing ventila tor-associated pneumonia rates. Except for August 1998, ventilator-associat ed pneumonia rates have been below the 75th percentile since May 1998. Conclusion: This study illustrates the effectiveness of a multidisciplinary team approach devised to reduce and stabilize ventilator-associated pneumo nia rates in a medical-surgical intensive care unit.