This is a pre-post implementation cohort study. This is a data driven quality improvement project which aims to improve the care of mechanically ventilated patients through the implementation of a bundle of evidence based practices, with a goal of reducing ventilator associated events and mortality.
NASAM is a national collaborative quality improvement project in Saudi Arabia which aims to: 1. Reduce the rate of ventilator-associated events 2. Improve the compliance with NASAM bundle elements 3. Reduce the mortality of mechanically ventilated patients The plan of this quality improvement project is to extend the implementation to a total of 100 ICUs in collaboration with multiple health systems across the country. A significant component of this project includes measuring the safety culture of ICUs.
Study Type
OBSERVATIONAL
Enrollment
27,966
Implementation of evidence-based practices
Intensive Care Unit, King Abdulaziz Medical City, National Guard Health Affairs
Riyadh, Saudi Arabia
King Abdullah International Medical Research Center
Riyadh, Saudi Arabia
Ventilator-associated events
Ventilator-associated events rate per 1000 ventilator days in 18 months
Time frame: 18 months
Sub-glottic endotracheal tube compliance rate
The percentage of ventilator days with sub-glottic endotracheal tube use
Time frame: 18 months
Head of bed elevation compliance rate
The percentage of ventilator days with head of bed elevation ≥30 degrees
Time frame: 18 months
Spontaneous awakening trial (SAT) compliance rate
The percentage of ventilator days with spontaneous awakening trial (SAT)
Time frame: 18 months
Percentage of ventilated patient days without sedation
The percentage of ventilated patient days without sedation use
Time frame: 18 months
Spontaneous breathing trials (SBT) compliance rate
The percentage of ventilator days with spontaneous breathing trial (SBT)
Time frame: 18 months
Percentage of ventilated patient days without neuromuscular blockers
The percentage of ventilated patient days without neuromuscular blockers
Time frame: 18 months
Percentage of out of bed mobility
The percentage of ventilated patient days with out of bed mobility
Time frame: 18 months
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Percentage of CAM-ICU negative (no delirium)
The percentage of ventilator days with CAM-ICU negative (no delirium)
Time frame: 18 months
90-day mortality
The 90-day ICU mortality rate of ventilated patients
Time frame: 90 days
Mechanical ventilation duration
The duration of mechanical ventilation in calendar days
Time frame: 90 days
ICU length of stay
The number of calendar days from ICU admission to discharge from ICU
Time frame: 90 days