AHRQ Safety Program for Mechanically Ventilated Patients
Instructions: This Sustainability Scorecard is a tool you can use to quickly assess your unit’s progress in applying the Comprehensive Unit-based Safety Program to the care of mechanically ventilated patients. For each question select one of the three answer choices found in the colored columns. After you have answered the questions for each section, total the number of responses that you selected for each column.
Thinking back to the last 6 months (circle one answer for each row)...
| Adaptive Work | Comprehensive Unit-based Safety Program (CUSP) | Red | Yellow | Green |
|---|---|---|---|
| What percentage of your staff has received education on the Science of Safety in the last 6 months? | 0–33% | 34–67% | 68–100% |
| What percentage of your staff has been surveyed about how to get the next patient off the ventilator faster? | 0–33% | 34–67% | 68–100% |
| How many defects have you identified and worked on within the last 6 months? | 0 | 1 | 2 or more |
| How many defects have you fixed on your unit within the last 6 months? | 0 | 1 | 2 or more |
| How many CUSP meetings has your unit held in the last 6 months? | 0–2 | 3–4 | 5 or more |
| How many CUSP meetings has your senior executive attended in the last 6 months? | 0–3 | 4–5 | 6 or more |
| How much of the time did you use Daily Goals for your patients in the last 6 months? | 0–60% | 61–80% | 81–100% |
| Count the number of your responses for each column → |
| Technical Work | Ventilator-Associated Events (VAE), Daily Care Processes, Early Mobility, Low Tidal Volume Ventilation | Red | Yellow | Green |
|---|---|---|---|
| How many months of VAE data have you collected in the last 6 months? | 0 | 1-3 | 4 or more |
| How many months of objective outcome measures data (e.g., total number of ventilator days, intensive care unit length of stay, total number of deaths) have you collected in the last 6 months? | 0–2 | 3–4 | 5 or more |
| How many of your mechanically ventilated patients received a RASS (Richmond Agitation-Sedation Scale) or SAS (Sedation-Agitation Scale) assessment? | 0 – 60% | 61 – 80% | 81 – 100% |
| How many of your patients received a delirium assessment? | 0 – 60% | 61 – 80% | 81 – 100% |
| How many of your eligible patients received a spontaneous awakening trial (SAT)? | 0 – 60% | 61 – 80% | 81 – 100% |
| How many of your eligible patients received a spontaneous breathing trial (SBT)? | 0 – 60% | 61 – 80% | 81 – 100% |
| How many of your patients receive tailored daily goals to maximize their mobility? | 0 – 60% | 61 – 80% | 81 – 100% |
| How often do you actively monitor positive end-expiratory pressure (PEEP), plateau pressure, and tidal volume to ensure that they are within the recommended ranges? | 0 – 60% | 61 – 80% | 81 – 100% |
| How often do you achieve the recommended ranges for PEEP, plateau pressure and tidal volume? | 0 – 60% | 61 – 80% | 81 – 100% |
| Count the number of your responses for each column → |
If you scored...
- Mostly red: Your unit is below target at implementing interventions.
- Mostly yellow: Your unit has been moderately successful at implementing interventions.
- Mostly green: Your unit has been successful in implementing the steps for this program, and you are on the right track.
For instructions and resources on how to effectively apply CUSP to the care of mechanically ventilated patients, visit Toolkit To Improve Safety for Mechanically Ventilated Patients.
For instructions and resources on how to implement any of the technical interventions (daily care processes, early mobility, low tidal volume ventilation), visit the Technical Bundles module of the Toolkit To Improve Safety for Mechanically Ventilated Patients.
