Details behind the dots: How different intensive care units used common and contrasting methods to prevent ventilator associated pneumonia.

Care bundles promote delivery of effective care and improve patient outcomes. The understanding of how to improve delivery of care bundles is incomplete. The Scottish Patient Safety Programme is a national collaborative with the aim of improving the delivery of care to patients in acute hospitals in Scotland.

Elimination of central-venous-catheter-related bloodstream infections from the intensive care unit.

Introduction: Central-venous-catheter (CVC)-related bloodstream infection (CRBSI) is a complication of intensive care stay which can have important adverse consequences for both patient and institution. There are a number of evidence-based interventions that reduce CRBSI, but it is recognised that consistently applying the best evidence every time is a challenge.

Methods: The authors set out to reduce CRBSI and introduced interventions in our intensive care unit (ICU) over a 4-year period using a quality improvement approach.

Reduction of ventilator-associated pneumonia: active versus passive guideline implementation.

Purpose: Ventilator-associated pneumonia (VAP) is associated with increased morbidity, mortality and costs. We describe an active, multifaceted implementation of a VAP prevention bundle designed to improve staff compliance with evidence-based actions and reduce the incidence of VAP.

Method: A 'VAP prevention bundle' was designed then implemented, first passively, then actively, as defined by a multimodal programme incorporating staff education, process measurement and outcome measurement and feedback to staff and organisational change.