Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Patient Safety Monitoring System (MPSMS).

Table

2.32 Percent of patients who experienced ventilator exposure with ventilator-associated pneumonia events, United States, 2002 and 2003.

Data Source

1. CMS, MPSMS, inpatient medical records: for abstracted data related to the index hospital stay.
2. CMS Medicare Administrative Data: used for 30-day post-procedure mortality.

Denominator

All patients who experienced ventilator exposure during the index hospital stay who did not have evidence of pneumonia prior to intubation or within 2 days of intubation/ventilation exposure.

Numerator

All patients who experienced intubation/ventilator exposure during the index hospital stay for more than 2 days without prior evidence of pneumonia.

Comments

Ventilator exposure is determined by documentation of a patient's use of a device to assist or control respiration continuously through a tracheostomy or by endotracheal intubation for at least 2 days. Devices include ventilators or other lung expansion devices delivering O2 via tracheostomy or endotracheal intubation.

Ventilator-associated pneumonia is determined by evidence in the medical record of new infiltrate, consolidation, or cavitations noted on chest X-ray at least 2 days after intubation, and documentation of physician diagnosis of postoperative pneumonia 2 or more days after intubation. The criteria to determine a ventilator-associated pneumonia event differ between 2002 and 2003 due to differences in the data elements collected.

In order to attain greater consistency between 2002 and 2003 data, the analytic approach used to produce these tables differs from earlier years of the NHQR.