Hospital

Ventilator-associated pneumonia (VAP) is themost common hospital-acquired infectionamong ventilator patients and has been associat-ed with extended hospital lengths of stay (LOS) and high-er rates of mortality for patients.1 Average VAP rates in hospitals across the United States vary from 2.9 VAPs per 1,000 ventilator days in pediatric ICUs to 15.2 VAPs per 1,000 ventilator days in trauma ICUs.2 Research has shown mortality rates ranging from 24 % to 50%, depend-ing on individual co-morbidities and pathogens involved.3 Although some studies have not found VAP to be an inde-pendent contributor to intensive care unit (ICU) mortal-ity,3 hospital-acquired pneumonia increases complexity of care, ICU LOS by 6.1 days, and hospital LOS by 10.5 days.4 Each VAP is estimated to add $40,000 to the cost of a patient’s care. Reductions of ventilator-associated pneumonia (VAP) associated with use of a bundle concept have recently been reported.5 As a known complication with significant mor-bidity and mortality, VAP has also become one of the pri-mary interventions for the 5 Million Lives Campaign, formerly known as the 100,000 Lives Campaign, initiated by the Institute for Healthcare Improvement (IHI).6 Mercy & Unity Hospitals of Minnesota implemented the IHI ventilator bundle concept as part of its participa-tion in an IHI Breakthrough Series collaborative on improving care in the ICU, which was conducted from June 2003 through May 2004. This articles reports on the work that Mercy & Unity Hospitals conducted within the collaborative. Implementing a Ventilator Bundle in a Communit