East Liverpool City Hospital in Ohio successfully reduces incidences of hospital-acquired VAP and CLABSIs

East Liverpool City Hospital began using prevention bundles several years ago to reduce hospital-acquired ventilator-acquired pneumonia (VAP) and central line-associated bloodstream infections (CLABSIs).  The hospital has not had a case of hospital-acquired VAP in 3 years or 1,291 ventilator days and has not had a case of CLABSI in 19 months or 2,448 central line days.  These are remarkable accomplishments and the hospital attributes its success to the consistent use of bundles, nursing-physician collaboration, and streamlined processes.  

The bundles used by East Liverpool City Hospital are described below:

VAP bundle

1. Keep the head of the patient’s bed raised between 30 and 45 degrees, unless other medical conditions prevent this
2. Check the patient’s ability to breathe on his or her own every day so that the patient can be taken off the ventilator as soon as possible
3. Clean their hands with soap and water, or an alcohol-based hand rub before and after touching the patient or ventilator
4. Clean the inside of the patient’s mouth on a regular basis
5. Clean or replace equipment between use on different patients

CLABSI prevention bundle

1. Washing hands with soap and water, or an alcohol rub
2. Wearing sterile clothing and taking barrier precautions such as wearing a mask, gloves, and hair covering, and fully covering the patient with sterile drape, except for a very small hole where the line is inserted
3. Cleaning the patient’s skin with chlorhexidine when the line is inserted
4. Finding the best vein to insert the line
5. Checking the line for infection each day

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