Special Programs Hospital-wide Rapid Response Team Our critical care nurses, doctors, and respiratory therapists make up the hospital-wide Rapid Response Team (RRT), answering calls for critical care expertise for any patient on any unit. At the first sign of decline, the RRT is called to evaluate and treat patients whose condition appears to be worsening. The goal is to stabilize them well before their condition deteriorates to a catastrophic level. Ventilator Associated Pneumonia (VAP) Prevention Program When patients need help breathing, they may be placed on a ventilator (breathing machine). If a patient is on a ventilator for more than 48 hours and contracts a lung infection, it is called Ventilator Associated Pneumonia (VAP). VAP is a very serious infection. At best it increases the time a patient spends on a ventilator and in the ICU; at worst it can be fatal. The Institute for Healthcare Improvement has identified best practices (or a ventilator bundle) to prevent VAP. When implemented together on all patients on mechanical ventilation, the result is dramatic. Our goal is 100% compliance with the complete ventilator bundle on all ICU ventilator patients unless otherwise contraindicated. We aggressively train all ICU personnel in VAP prevention techniques, use formal order sheets with components to be done, maintain a well-defined infection control program, and track results so we know that every part of the process is working. Our efforts have proven to be very successful. Central Line Associated Infection Prevention Program A central line is a special intravenous catheter or IV that goes into one of the large, central circulation blood vessels. A central line is needed to give the medical team access to a large vein that can be used to give fluids, blood, nutrition, or medication that might be irritating to smaller veins. It can also be used for intensive cardiovascular monitoring and for assessment of fluid status. While central lines can be extremely helpful, bacteria can grow in the line and spread to the patient's bloodstream. This can be a life-threatening condition. The Institute for Healthcare Improvement has identified best practices (or a central line bundle) to prevent VAP. This central line bundle has been shown to dramatically reduce infection rates. The Highland ICU goal is 100% compliance with the complete central line bundle on all central line patients unless contraindicated. We aggressively train all ICU personnel in central line infection prevention techniques, use a standardized insertion approach that includes monitoring of every insertion, maintain a well-defined infection control program, and track results so we know that every part of the process is working. We report our outcomes to the state each month and trend very positively with our prevention efforts. Palliative Care Program Palliative care, also called comfort care, emphasizes the relief of pain, symptoms, and stress of serious illness. The goal is to prevent and ease suffering and to offer patients and their families the best possible quality of life. Palliative care is available to Highland ICU patients whether or not life-prolonging treatments are being provided. Our doctors, nurses, social workers, and chaplains are available to offer patients and families spiritual comfort, psychological support, and help in making life-and-death decisions.