22-275 / Pneumonia Zero (NZ) Programme

Spain
GOP Information  
 
Organisation sharing the GOP
Related practices from PaSQ database
Ministry of Health, Social Services and Equality (MSSSI)

Topic

Patient safety system
Quality improvement project
Category
Pneumonia prevention
Implementation of Patient Safety initiatives / Activities
GOP Description
 
Implementation level
National
Regional
Local
Clinical settings
Intensive care units (ICUs)
Objectives
-Main_objective: to decrease the national mean incidence_density_rate_(ID) of ventilator_associated_pneumonia-(VAP) to <9 cases per 1.000 ventilator-days, which means to decrease the rate by 40% in comparison with the mean 2000-2008 rate and by 25% in comparison with the mean 2009-2010 rate.
-Secondary_objectives:
*Promote_and_improve patient_safety_culture in NHS_ICUs.
*Sustain_and_strengthen the_net_of_ICUs implementing evidence_based_effective_safe_practices
Population
All patients admitted to the participating ICUs
All adult ICUs from the 17 Health Regions from the NHS are invited to participate
Methods
 
Methodology
-Phases:
1.Information_and_training of healthcare workers on VAP prevention: centralized for ICU team leaders and local sessions and on-line course for all ICU staff.
2. Dissemination and implementation of the care bundle: joint sessions with medical and nursing staff
3.Analysis and evaluation: monthly data collection in a common on-line platform; monthly ICU sessions for evaluation and feedback. Every 3 months, identification and discussion of detected weaknesses and setting of objectives for improvement.
-Content of the NZ bundle: 2 complementary sets of practices
*STOP VAP includes 7 basic compulsory practices and 3 specific highly recommended practices to prevent VAP
*A comprehensive safety plan (PSI): seeks to promote and strengthen patient safety culture in the ICUs daily work
-Programme organization:
*National-coordination team: Scientific societies of intensive care doctors and nurses (SEMICYUC and SEEIUC); MSSSI
*Regional-coordination-team: as decided by each Region
*Local-coordination-team: MD & nurse in each participant ICU (approved by the hospital management).
Timeframe implementation
Final analysis of results after 21 months is being carried out. In the first 12 months of implementation preliminary positive results have already been shown.
Implementation tools available
-On line training tools
-Posters
-Spanish version of the Hospital Survey on Patient Safety
-Specific tools: Walk rounds; Learning from errors framework and survey; daily goals; on line risk factors registration form
-Support documents (protocol, evidence report, technical guidelines for STOP VAP clinical practices)
Implementation cost
Funds for Health Regions: 279,099 €
Technical management: 90,000 €
Results
 
Method used to measure the results
ID rate: VAP /1000 ventilator-days
The local ICU team monthly registers the global ICU risk factors, including ICU patient-days and ventilator_days.
When a patient develops VAP a new register is open with information from the patient and the infection according to the ENVIN-HELICS (National ICU Infection Surveillance Study) system: http://hws.vhebron.net/envin-helics/
Results
239 ICUs from all Health Regions have provided data to the programme and 76.2% of them have participated for more than 12 months.
Preliminary results: in the first 12 months of the program the national ID rate has dropped from 9.4 to 6.9
Around 18,000 professionals have received online training.
Analysis of the results
The longer the participation in the programme, the lower ID
The estimated impact after the registration of 500,000 ventilator_days:
2,330 fewer pneumonias
280 fewer deaths
43,305 fewer hospital stays (143.000.000 € savings for the NHS)
Implementation barriers
 
Did you find implementation barriers?
Yes
Please describe implementation barriers
.Resistance to accept the project and the needed tools, mainly the PS interventions
.Some budget did not reach the ICU participants
.Resources restrictions
Describe the strategies used to overcome the barriers (If needed)
.Continuous contact between coordinator teams
.Two meetings every year to present the results (aggregated and by HR), problems detected and improvement proposals
.Adaptation of tools if needed (“daily goals”,etc)
.Letters to the hospital managers to support the project
.Promoting leadership.
Other information
 
Other information about the GOP that you would like to add (Link or attached document)
Link to the NZ platform:
http://hws.vhebron.net/neumonia-zero/Nzero.asp

There is no specified text here
Contact information
 
Name: Yolanda Agra
Position/function: Senior Adviser
Department: General direction of Public Health, Quality and Innovation
Organisation: Ministry of Health, Social Services and Equality
City: Madrid
Country: Spain
Region: Madrid
E-mail: yagra@msssi.es
Phone: 34915964102
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