Ventilator Bundle

Number of intensive care unit patients on mechanical ventilation at time of survey for whom all five elements of the ventilator bundle are documented and in place. The ventilator bundle elements are:
• Head of bed (HOB) elevation 30 degrees or greater (unless medically contraindicated); noted on 2 different shifts within a 24 hour period
• Daily “sedation interruption” and daily assessment of readiness to extubate; process includes interrupting sedation until patient follow commands and patient is assessed for discontinuation of mechanical ventilation; Parameters of discontinuation include: resolution of reason for intubation; inspired oxygen content roughly 40%; assessment of patients ability to defend airway after extubation due to heavy sedation; minute ventilation less than equal to 15 liters/minute; and respiratory rate/tidal volume less than or equal to 105/min/L(RR/TV< 105)
• Peptic ulcer disease prophylaxis
• Deep venous thrombosis prophylaxis
• Daily oral care with Chlorhexidine