Author Biographical Info

Sarah Senger, BSN, RN, CCRN, is a Doctor of Nursing Practice (DNP) candidate in the Adult-Gerontological Acute Care Nurse Practitioner (AGACNP) program at the University of Texas Health Science Center at Houston. She brings nearly a decade of critical care nursing experience, with clinical expertise spanning cardiovascular, medical, and burn intensive care settings. Ms. Senger will be practicing as a cardio-intensivist advanced practice provider in the Cardiovascular Intensive Care Unit at Methodist Hospital San Antonio post graduation, a quaternary care center and the only heart transplant facility in South Texas. Her professional background includes advanced hemodynamic monitoring, management of mechanical circulatory support devices, and care of complex post-operative cardiac surgical patients. She has served as a preceptor, adjunct clinical faculty, and research assistant, and has been actively involved in quality improvement initiatives, including participation in the AACN Clinical Scene Investigator Academy. Ms. Senger is a member of Sigma Theta Tau International Honor Society of Nursing and the American Association of Critical-Care Nurses. Her doctoral project focuses on enhancing compliance with the ventilator bundle to reduce the incidence of ventilator-associated pneumonia in a high-acuity cardiovascular ICU setting.

Date of Doctor of Nursing Practice Project Completion

Summer 8-15-2025

Faculty Advisor

Dr. Linda Cole

Abstract

Purpose: This project aimed to evaluate the effectiveness of an intervention to improve ventilator bundle compliance and reduce ventilator-associated pneumonia (VAP) rates in a cardiovascular intensive care unit (ICU).

Background: VAP is a major complication in mechanically ventilated patients, leading to increased morbidity and healthcare costs. Implementing evidence-based practices, such as the ventilator bundle, has reduced VAP rates. However, inconsistent compliance with these practices remains a challenge.

Methodology: A three-month quality improvement project was conducted in a cardiovascular ICU. Process measures included oral care compliance and head-of-bed elevation, which were tracked weekly through patient charts and infection prevention reports. The intervention involved staff education, adherence monitoring, and regular feedback. VAP rates were tracked as the primary outcome measure.

Results: Following the intervention, oral care compliance improved from 42% at baseline to a peak of 78%, with an average of 64% over the intervention period. HOB elevation compliance improved from 38% at baseline to a peak of 72%, with an average of 58% post-intervention. Despite improved compliance, VAP rates increased from 0 cases per 1,000 ventilator days (556 days total) before intervention to 2.5 cases per 1,000 ventilator days (778 days total) after intervention.

Implications: The project highlights the importance of staff education, regular monitoring, and feedback in improving VAP prevention practices. While further evaluation is needed to confirm long-term impacts, the findings underscore the value of evidence-based interventions in enhancing patient safety in critical care. Future projects should focus on expanding the intervention to other ICU settings and evaluating its cost-effectiveness.

Keywords

ventilator-associated pneumonia, ventilator-associated events, critical care nursing, pneumonia

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