1. CUSP4MVP - VAP Comprehensive Unit-based Safety Program for Mechanically Ventilated Patients – Ventilator Associated Pneumonia Daily Care Process Measures Registry Tara McFarlin Allison Ord

2. Overview of the Daily Care Process Measures Data Entry and Data Upload Review of Daily Care Process Measures Performance Monitor Review of Network Performance and Reports Page Daily Care Process Measures Registry – Training Overview

3. Home Page Site can be accessed directly at: https://armstrongresearch. hopkinsmedicine.org https://armstrongresearch. hopkinsmedicine.org Option to login on or browse. Some pages only available with log-in The “Return to Armstrong Institute – Home” will take you back to the Armstrong Institute’s homepage Clicking on Project will take you to the Project Home Page

4. Tools that Focus on Eliminating Ventilator- Associated Pneumonia CUSP4MVP-VAP Home Page

5. Networks Admins vs Members Member’s Permissions Enter data into the CUSP4MVP-VAP tools View reports from the CUSP4MVP-VAP Daily Care Process Measures Tool Administrator’s Permissions Administrators have all the functionality of members and can also: Invite users to participate into the Network View the Network Performance Monitor Send out HSOPS invitations View HSOPS reports Members or Administrators can be part of many Networks There can be multiple administrators within a Network Networks and their hierarchy are configured by Armstrong Institute

6. My Projects Shows all the available projects and will highlight the one(s) you are participating in You will be prompted to login before accessing this page Clicking on the project will take you to the CUSPMVP-VAP Project page Mary Schmidt

7. CUSP4MVP-VAP My Tools Page Ability to Search by Tool Allows you to quickly access various tools your network(s) are registered for. Coordinating Entities will have the ability to view Tools registered to their Children networks. Mary Schmidt CUSP4MVP-VAP Test Network Tool Name Network which Data will be Entered for Search by Tool Name or by Network Name

8. Manage/View CUSP4MVP-VAP National Tools CUSP4MVP-VAP Project Page Displays your data entry tools Your access to a tool is determined by your role - whether you are a member or an administrator. For example, only administrators will see the “Manage” button for HSOPS. Viewing for Community Memorial WICU as Mary Schmidt Network Admins see the Manage or Register Button Displays the Network entering data. Ability to click on network name to navigate to network

9. My Networks View Networks Shows all the Networks that you are associated with Ability to search by name of Network Mary Schmidt

10. CUSP4MVP-VAP Project Page The first time entering the page, you’ll see the “Register” button Please note, apps that aren’t yet launched will display with “Coming Soon” Once registration is complete, the button will change to display “Manage” Mary Schmidt Viewing for Community Memorial WICU as Mary Schmidt

11. CUSP4MVP-VAP Registration The first time accessing the Daily Care Process Measures app, the following registration information will be required. Community Memorial WICU

12. Enter data by accessing the Events Tab Sort previous entries by Column Titles Sort by Filter Criteria as well Ability to Edit or Delete entries Daily Care Process Measures Add New Event

13. Daily Care Process Measures – Data Entry Data entry grid opens in modal overlay. Date validation enabled on form.

14. Daily Care Process Measures – Data Entry Help icons available for each data entry field.

15. Daily Care Process Measures – Data Entry Sub-G ETT: Does patient have a subglottic suctioning endotracheal tube (ETT)? Sub-G ETT Con: Why is the use of a Sub-G ETT contraindicated? Sub-G ETT Con: Why is the use of a Sub-G ETT contraindicated? Enter ‘Sub-G ETT’ criteria

16. Enter ‘HOB’ criteria. All fields are enabled with validation Daily Care Process Measures – Data Entry Is ‘HOB’ at or over thirty degrees from the horizontal? If not, why?

17. Daily Care Process Measures – Data Entry Enter ‘RASS’ if unit uses Richmond Agitation Sedation Scale Enter ‘SAS’ if unit uses Riker Sedation-Agitation Scale Enter ‘NU’ if not sedation scale is in use, or uses a scale other than RASS or SAS. If ‘NU’ is entered, skip to the ‘Delirium Assessment’ column. Don’t enter info into ‘Target’ or ‘Actual’

18. Daily Care Process Measures – Data Entry For RASS or SAS, please enter the score closest to 10:00 am. If two scores were collected equidistant from 10:00 am, choose the earlier score. Target Scores vs. Actual Scores

19. Daily Care Process Measures – Data Entry Target Scores vs. Actual Scores For RASS or SAS, please enter the score closest to 10:00 am. If two scores were collected equidistant from 10:00 am, choose the earlier score.

20. Daily Care Process Measures – Data Entry Enter ‘CAM-ICU’ if unit uses Confusion Assessment Method Enter ‘ASE’ if unit uses Attention Screening Exam Enter ‘NU’ if neither method in use to assess patient confusion

21. Daily Care Process Measures – Data Entry Please record the most recent CAM-ICU or ASE assessment closest to 10:00 am. CAM-ICU – Is the patient positive or negative for delirium? ASE – What is the patient’s ability to pay attention?

22. Daily Care Process Measures – Data Entry SAT – Has the patient had a Spontaneous Awakening Trial today? SAT Con – If no, what is the reason a SAT is not appropriate for this patient today?

23. Daily Care Process Measures – Data Entry SBT – Has the patient had a Spontaneous Breathing Trial today? SBT Con – If no, what is the reason a SBT is not appropriate for this patient today?

24. Daily Care Process Measures – Data Entry SBT with Seds off? – Was the SBT performed with the sedatives off? Evaluate daily for patients receiving mechanical ventilation AND with a ‘Y’ entered in the SBT column: Enter ‘Y’ if the SBT was performed with the sedatives turned off. Enter ‘N’ if the SBT was performed with the sedatives on. Enter ‘NK’ if you don’t

25. Enter ‘N’ if the patient is not currently intubated/trached and mechanically ventilated. Daily Care Process Measures – Data Entry

26. Enter ‘E’ if there is no patient in the bed. Daily Care Process Measures – Data Entry

27. Tip - Click ‘Done’ after 10 – 12 records have been entered. Daily Care Process Measures – Data Entry

28. Daily Care Process Measures Add New Event Enter data by uploading a spreadsheet – very convenient!

29. Daily Process Care Measures Add New Event via Upload

30. Daily Process Care Measures Add New Event via Upload

31. Daily Process Care Measures Add New Event via Upload Template & Definition File

32. Daily Process Care Measures Add New Event via Upload Community Memorial WICU

33. Daily Process Measures Reports Sedation Scale Now available within the VAP Daily Rounding tool or from the My Networks – My Reports or My Networks – My Performance Monitor Trending - quick snap shot of rate changes

34. Daily Process Measures Reports Delirium Assessment My Rate will show your performance rate as well as an indicator of whether “Higher is Better” or “Lower is Better”

35. Daily Process Measures Reports View Chart Interactive chart that allows selection of your comparators and time periods Hover over data point to display your rate and the comparators Ability to download PDF Ability to turn comparators ON and OFF

36. Daily Process Measures Compliance Reports Improvement Opportunities display the number of events, which if eliminated improve your measure value

37. Average Performance displays the mean for all the other participants in VAP. My Percentile shows what percentile your rate is versus all other participants in VAP Daily Process Measures Contraindication Reports

38. Distribution tab displaying frequency charts of various data collection points Daily Process Measures Distribution Reports

44. My Networks My Network Performance Network Admins will see the measures from the Daily Process Measures Tool for each of the networks they are associated with Reports available for download

45. If Networks are in a hierarchy, you will have the ability to expand to see each Network’s rate Reports available for download Search for Measures by Name My Networks My Network Performance Ability to search for Measures by Name Ability to sort by Time Period Download Excel or PDF Reports

46. My Networks My Reports Allows you to run all reports from a single interface. Reports are also available within their specific data entry tool. Tools, Networks and Reports are displayed based upon what you are associated with

47. Recommended System Requirements Firefox 17.0+, Chrome, Internet Explorer 8.0+, Safari 4.0+ Adobe Acrobat 5.0+ (For downloading reports) Excel 2000 + (For downloading reports) Broadband connection with 500+ Kbps

48. Support Technical Support Contact Information: cusp4mvp@jhmi.edu lifetimesupport@cecitysupport.com

49. Thank You! Questions?