Audit of UK ventilator care bundles and discussion of subglottic secretion drainage.

AIMS: The UK Department of Health (2012) recommends a ventilator care bundle in the form of a high impact intervention to reduce the incidence of ventilator-associated pneumonia. The aims of this project were to audit compliance with individual components of this care bundle in the UK.

DESIGN: The first survey directly addressed compliance with each component of the recommended ventilator care bundle. The second survey was targeted towards the use of subglottic secretion drainage (SSD) and the logistics of implementing it.

METHODS: The first survey was distributed electronically to the Nurse Leads of the Critical Care National Network Nurses Forum and then circulated more widely through local networks. This Forum covers England, Wales and Northern Ireland. The second survey was circulated electronically to the Intensive Care Society Linkmen and was UK-wide.

RESULTS: The first survey received 112 responses following circulation via 40 Leads. Ninety-nine percent of responses were from nurses, the rest were from doctors. The second survey had 77 responses, 88% from doctors and was circulated via 155 Linkmen. The surveys showed that over 95% of respondents worked in intensive care units that use a ventilator care bundle. Compliance with each component of the bundle was greater than 85% in all units, except for SSD, which was performed in 47-53% of the units.

CONCLUSIONS: In this survey, most units comply with most of the nationally recommended ventilator care bundle components with the exception of SSD. Because of a lack of availability of suitable endotracheal tubes, a significant number of patients are being re-intubated to facilitate this therapy.

RELEVANCE TO CLINICAL PRACTICE: Compliance with most components of the nationally recommended ventilator care bundle is good. SSD has not been as widely implemented as the other components and patients are undergoing re-intubation to facilitate it.