Hospital case management : the monthly update on hospital-based care planning and critical paths
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By implementing an innovative set of ventilator protocols, case managers at Nash General Hospital in Rocky Mount, NC, have cut length of stay for ventilator patients by 34%, reduced the average duration of mechanical ventilation by 38%, and saved the hospital an average of $35,000 in charges per ventilator patient. Elements of the protocol include using pulse oximetry in place of autologous blood gases when possible, performing a chest X-ray and initiating tube feeding immediately after the patient is placed on the ventilator, taking sputum cultures to determine a baseline for organism growth and the need for antibiotics, and weaning the patient at certain oxygen levels. Ventilator collaborative team members are also examining the possibility of adding a kinetic therapy element to the protocols.