Definition

ARDS Net clinical trials suggest that maintaining inspiratory plateau pressures < 30 cm H2O (when accompanied by a low-tidal volume ventilation strategy of 6 mL/kg) reduces mortality in patients with lung injury.  Most mechanically ventilated patients with severe sepsis and/or septic shock will meet criteria for lung injury or acute respiratory distress syndrome and could benefit from inspiratory plateau pressures < 30 cm H2O.

Compliance with this bundle element is defined as the percent of patients requiring mechanical ventilation who have a median IPP < 30 cm H2O over the first 24 hours following presentation with severe sepsis and/or septic shock.

Numerator: Number of mechanically ventilated patients with severe sepsis and/or septic shock who had a median IPP < 30 cm H2O over the first 24 hours following presentation with severe sepsis and/or septic shock

Denominator: Number of mechanically ventilated patients presenting with severe sepsis and/or septic shock

Exclusion: Patients not mechanically ventilated

Goal

Increase the number of cases of mechanically ventilated patients with severe sepsis and/or septic shock who maintain inspiratory plateau pressures < 30 cm H2O to 100 percent.

Data Collection Plan

Data is collected for this measure on each individual patient using the Individual Chart Measurement Tool. This can be done concurrently or retrospectively as detailed.

Note: To assist calculation of the median inspiratory plateau pressure value over 24 hours, there is an optional Median Plateau Pressure Calculation Tool  that allows the various values to be arranged in order and describes how to calculate the median value. Once done with this tool, record the result on the Individual Chart Measurement Tool.

Once all the Individual Chart Measurement Tools have been collected for the month, use the Monthly Measurement Worksheet to integrate the data by combining the results of all the Individual Chart Measurement Tools.

At the end of each section on the Monthly Measurement Worksheet you will find a line designated “Numerator” and a line designated “Denominator,” which are ready for input into the pre-configured Improvement Tracker for the measure.

Related Changes

Prevent Excessive Inspiratory Plateau Pressures

Sample Graph

Use Improvement Tracker to enter, save, and graph your team's data.