VAP is about to be revamped! The current criteria used to determine and track ventilator associated pneumonia (VAP) are undergoing an overhaul.
Through the National Healthcare Safety Network (NHSN), the CDC, in cooperation with other subject matter experts and organizations, has formed a working group to review and update the “surveillance definitions” for what they are calling ventilator associated events (VAEs) of which VAP is but one possibility. The new proposed NHSN surveillance definition algorithm, set to roll out in 2013, establishes more reliable and objective clinical measures for determining ventilator associated conditions (VACs) moving away from “criteria that are less likely to be influenced by variability in resources, subjectivity and clinical practices.” As implementation of the new criteria begins, it is reasonable to expect a retread of the current ventilator bundle as well. While improved criteria are warranted and good, it is left to be seen how these updates will affect the level of VAP incidences now reported. Will they go up initially and perhaps level off? Will the new algorithm separate pre-hospital infections from those acquired “in house”? How will this affect CMS reimbursements for nosocomial infections? We may well ponder the words of noted journalist Arnold Bennet; “Any change, even a change for the better, is always accompanied by drawbacks and discomforts.”