Using a Human Factors Approach to Assess Program Evaluation and Usability of the Ventilator Associated Pneumonia Protocol

Abstract

Ventilator-associated pneumonia (VAP) is a healthcare-associated infection (HAI), or more specifically, a healthcare-associated pneumonia (HAP) that can lead to significant morbidity and mortality in hospitalized patients that are being mechanically ventilated. There are established evidence-based guidelines in existence designed to reduce or eliminate VAP from occurring and when properly maintained have been shown to reduce the incidence of VAP. Nurses are at the frontline adhering to the VAP protocol through its integration into their workflow. It is yet unknown what elements of the protocol and workflow contribute to a successful VAP reduction in occurrence and increased patient safety. This program evaluation project, guided by an adapted Systems Engineering Initiative for Patient Safety (SEIPS) model, takes a human-factors approach towards answering these questions. It specifically examines the VAP protocol in a large urban southwestern teaching hospital to evaluate program effectiveness using a human factors approach. Building on the work of Carayon, et al. (2006) and Jansson et al. (2013), I present the findings from this program evaluation project using an adapted SEIPS model that sought to evaluate the VAP prevention program from a human factors perspective addressing the following aims: Aim 1. Determine the effectiveness of using the adapted SEIPS model to evaluate a VAP quality improvement (QI) project; Aim 2. Evaluate a VAP QI program taking a human factors approach; and Aim 3. Using the adapted SEIPS model, identify elements of the VAP bundle that nurses perceive as strength and weaknesses. The project was completed with the following findings: Based on this work the adapted SEIPS model demonstrates usefulness for evaluating QI projects. It would be interesting to continue this work with QI projects to see how well it performs.