CDC Prevention Epicenters Wake Up and Breathe Collaborative

Ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation
associated with significant morbidity, including prolongation of mechanical ventilation and
increased ICU and hospital length-of-stay. Numerous strategies have been proposed to
decrease the occurrence of VAP among ventilated patients. Most notably, optimizing the use
of daily sedative interruptions and daily spontaneous breathing trials can improve sedative
management, decrease ventilator time, improve outcomes for mechanically ventilated
patients,and possibly decrease VAP.Combining daily sedative interruption with daily
spontaneous breathing trials confers additive improvement in ventilator days, intensive care
days, and possibly mortality compared to daily spontaneous breathing trials alone.

The primary aim of this study is to determine the impact of an opt-out protocol for paired
daily sedative interruptions and spontaneous breathing trials on VAP rates using a new
streamlined VAP definition. The investigators will evaluate the responsiveness of CDC's
proposed new surveillance definitions for ventilator-associated events to this quality
improvement initiative. The study will be nested within the Epicenters Streamlined versus
Conventional VAP Surveillance Study. Nine of the 18 hospitals in the larger study will be
participating in this intervention arm.