NCLIP

Ventilator-Associated Events Prevention Bundle

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Ventilator-Associated Events Prevention Bundle

Key Points

  • VAE prevention requires a coordinated daily bundle rather than single isolated actions.
  • Key bundle actions include sedation minimization with paired awakening-breathing trials, early mobility, and conservative fluid/transfusion strategies.
  • Oral care with chlorhexidine and low tidal-volume ventilation are core supportive prevention elements.

Equipment

  • Ventilator with low tidal-volume strategy capability
  • Sedation and awakening-breathing trial protocol tools
  • Mobility-assessment and early-mobility support resources
  • Oral-care supplies including chlorhexidine products per protocol

Procedure Steps

  1. Confirm patient is receiving invasive ventilation and requires VAE risk-reduction bundle.
  2. Review sedation level and target lowest safe sedation exposure.
  3. Coordinate daily spontaneous awakening trial and spontaneous breathing trial when clinically appropriate.
  4. Implement early mobility plan at the highest safe activity level for current condition.
  5. Review fluid status and apply conservative fluid-management strategy with the care team.
  6. Support conservative transfusion thresholds per ordered critical-care plan.
  7. Perform oral care with chlorhexidine according to protocol.
  8. Maintain low tidal-volume ventilation strategy and reassess pressure-volume safety trends.
  9. Re-evaluate bundle adherence at each shift and handoff.
  10. Escalate any missed bundle elements or rising risk factors immediately.

Common Errors

  • Running sedation deeper than necessary without daily reassessment → increased VAE risk and delayed liberation.
  • Skipping awakening-breathing trial pairing → missed opportunity for earlier ventilator de-escalation.
  • Inconsistent oral-care and mobility execution → preventable complication burden.
  • Ignoring fluid/transfusion excess trends → higher risk of pulmonary deterioration.

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