Implementation of the "FASTHUG" concept decreases the incidence of ventilator-associated pneumonia in a surgical intensive care unit

Abstract

Background: Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in critically ill patients. The Institute for Healthcare Improvement 100,000 Lives Campaign made VAP a target of prevention and performance improvement. Additionally, the Joint Commission on Accreditation of Health Organizations' 2007 Disease Specific National Patient Safety Goals included the reduction of healthcare-associated infections. We report implementation of a performance improvement project that dramatically reduced our VAP rate that had exceeded the 90 th percentile nationally.

The ventilator care bundle and its impact on ventilator‐associated pneumonia: a review of the evidence

“…Several of the studies reviewed employed additional elements (interventions) that were bundled with the original VCB (see Table 1). The VCB used by Papadimos et al (2008) was part of the FASTHUG bundle (Vincent, 2005) and included feeding assessment, blood glucose monitoring and pain assessment elements. The evidence for these additional elements is not based on research of patients who are mechanically ventilated and therefore they may not be suitable as VCB components.…”

The KIDS SAFE Checklist for Pediatric Intensive Care Units

“…In our project, we did not address the setting for application of the checklist. Published articles suggest that checklists can be used in several situations, including bedside rounds, 9,10,[12][13][14]103 as attachments to clinical pathways, 107 by individual clinicians, 13 and during shift-to-shift handover. 105 A limitation of our study is that the team members who used the NGT were volunteers from a single tertiary center; however, they were informed by international literature and followed an established and rigorous process to ensure systematic decision making.…”

“…The effectiveness of this mnemonic in improving morbidity and mortality outcomes and communication has been demonstrated in a few studies. 13,14 When attempting to apply this checklist in the pediatric ICU (PICU), we found that FASTHUG has several inadequacies. Specifically, it does not support holistic pediatric care by incorporating the physiology and development requirements of children as indicated in the literature (eg, glucose control 15 ).…”

“…A well-known checklist for adult ICU patients, known as FASTHUG, 13,14 is a mnemonic to remind ICU staff to consider feeding, analgesia, sedation levels, thromboembolic prophylaxis, headof-the-bed elevation, ulcer prophylaxis, and glucose control for each patient each day. The effectiveness of this mnemonic in improving morbidity and mortality outcomes and communication has been demonstrated in a few studies.…”

Prevention of Nosocomial Infection in the Neurosciences Intensive Care Unit: Remember the Basics

“…This has been validated to improve at least the documentation of care processes. Individual units have developed their own variations of this critical care ''housekeeping'' to prevent nosocomial complications [32][33][34][35]. A culture of regular patient review is inexpensive and creates an environment where attention is focused on the patient in context rather than just management associated with the primary condition such as head injury or intracranial bleed.…”