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Ventilator Care Bundle

The ventilator-associated pneumonia (VAP) reduction care bundle is a grouping of evidence-based, high-impact interventions. In its original form, it was an early example of the Institute for Healthcare Improvement (IHI) care bundle methodology in the US (what is a bundle?).

In the current IHI version, there are five components, which are those with the highest levels of evidence. :

  • raised head of bed (minimises microaspiration)
  • daily sedation hold and assessment of readiness to extubate (decreases length of stay)
  • peptic ulcer prophylaxis (minimises complications and length of stay)
  • venous thrombo-embolism prophylaxis (minimises complications and length of stay)
  • oral care with chlorhexidine (minimises microaspiration - added May 2010)

The care bundle methodology was adopted early in the UK, initially by the Modernisation Agency and then via multiple agencies including NPSA. The current UK recommended version adds:

  • Subglottic aspiration (minimises microaspiration)