WBC Count < 4,000 & band forms 2 ≥50% 4,000 and 11, 000 0 ≥ ≤ < 4,000 1 > 11,000 1 > 11,000 & band 2 ≥50% Tracheal Secretions: None or 0 Non-Purulent 1 Purulent 2 PaO2/FIO2: > 240, ARDS* or Pulmonary Contusion 0 240 and no ARDS* 2 ≤ * ARDS is defined as P/F PAWP 18 mmHg and acute bilateral infiltrates ≤200, ≤ X-Ray No infiltrate 0 Diffuse (or patchy) infiltrate 1 Localized Infiltrate 2 CPIS TOTAL ACTION Evaluate for potential 6 and low suspicion for VAP ≤ sources of infection 6 and high suspicion for VAP Evaluate as if CPIS > 6 ≤ & perform a > 6 BAL Team Members Performing Procedure (W= with supervision, W/O = without supervision) RRT/RCP CRT/RCP RCP Student W/O Education/Competency If no, still responsible for knowing P&P! Yes/No Type Frequency Ventilator associated pneumonia (VAP) in-service Initial service implementation with post test. Department orientation. Initial service implementation Mini-BAL procedure in-service ICU department orientation Mini-BAL procedure direct observation. Therapist Yes will perform 3 observed procedures with a supervisor Initial service implementation or RCS Education Staff. A Mini-BAL Competency ICU department orientation Evaluation sheet will be completed on each review. A peer will observe Supervisors and Education Staff. A Mini-BAL Competency Evaluation Sheet will be Every three years completed.
WBC Count < 4,000 & band forms ≥50% 2 ≥ 4,000 and ≤ 11, 000 0 < 4,000 1 > 11,000 1 > 11,000 & band ≥50% 2 Tracheal Secretions: None or 0 Non-Purulent 1 Purulent 2 PaO2/FIO2: > 240, ARDS* or Pulmonary Contusion 0 ≤ 240 and no ARDS* 2 * ARDS is defined as P/F ≤200, PAWP ≤ 18 mmHg and acute bilateral infiltrates X-Ray No infiltrate 0 Diffuse (or patchy) infiltrate 1 Localized Infiltrate 2 CPIS TOTAL ACTION ≤ 6 and low suspicion for VAP Evaluate for potential sources of infection ≤ 6 and high suspicion for VAP Evaluate as if CPIS > 6 > 6 & perform a Team Members Performing Procedure (W= with supervision, W/O = without supervision) RRT/RCP CRT/RCP RCP Student W/O Education/Competency If no, still responsible for knowing P&P! Yes/No Type Frequency Yes Ventilator associated pneumonia (VAP) in-service with post test. Initial service implementation Department orientation. Mini-BAL procedure in-service Initial service implementation ICU department orientation Mini-BAL procedure direct observation. Therapist will perform 3 observed procedures with a supervisor or RCS Education Staff. A Mini-BAL Competency Evaluation sheet will be completed on each review. Initial service implementation ICU department orientation A peer will observe Supervisors and Education Staff. A Mini-BAL Competency Evaluation Sheet will be completed. Every three years BAL