OBJECTIVES : To conduct a systematic literature and internet review of healthcare quality in the context of hospital-acquired pneumonia. Here, we report results related to the effectiveness of VAP guideline-recommended care bundles.

METHODS : A literature review of healthcare quality in the context of hospital-acquired pneumonia was conducted in a systematic manner. Five domains related to healthcare quality were emphasized during the review: Developing guidelines and improvements for care, using data to monitor outcomes, reimbursement penalties for quality (no examples of reimbursement rewards were found) certification of providers and health plans, and developing and endorsing quality measures. These terms were also cross-referenced these terms with the top 10 US News and World Report hospitals.

RESULTS : Our search yielded 489 results, 40 of which were relevant to our review. Of these, 6 were pertinent to the effectiveness of VAP guideline-recommended care bundles. Published literature demonstrated reduced incidence of ventilator-associated infection rates following implementation of the VAP bundle recommendations. In one study, infection rates were reduced to zero over a 10-year period following implementation of CDC-recommendations.

CONCLUSIONS : Existing evidence largely supports the effectiveness of the Institute for Healthcare Improvement’s “VAP bundle.” Variations of these guidelines have been implemented in pediatric units with positive outcomes. Methods to improve provider adherence to care bundles are crucial to maximizing outcomes.