A program for sustained improvement in preventing ventilator associated pneumonia in an intensive care setting

Raquel A Caserta; Alexandre R Marra; Marcelino Souza Durão Jr; Cláudia Vallone Silva; Oscar Fernando Pavao dos Santos; Henrique Sutton de Sousa Neves; Michael B Edmond; Karina Tavares Timenetsky

doi:10.1186/1471-2334-12-234

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A program for sustained improvement in preventing ventilator associated pneumonia in an intensive care setting

Journal article

Open access

Peer reviewed

A program for sustained improvement in preventing ventilator associated pneumonia in an intensive care setting

Raquel A Caserta, Alexandre R Marra, Marcelino Souza Durão Jr, Cláudia Vallone Silva, Oscar Fernando Pavao dos Santos, Henrique Sutton de Sousa Neves, Michael B Edmond and Karina Tavares Timenetsky

BMC infectious diseases, Vol.12(1), 234

09/29/2012

DOI: 10.1186/1471-2334-12-234

PMCID: PMC3521195

PMID: 23020101

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https://doi.org/10.1186/1471-2334-12-234View

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Abstract

Ventilator-associated pneumonia (VAP) is a common infection in the intensive care unit (ICU) and associated with a high mortality. A quasi-experimental study was conducted in a medical-surgical ICU. Multiple interventions to optimize VAP prevention were performed from October 2008 to December 2010. All of these processes, including the Institute for Healthcare Improvement's (IHI) ventilator bundle plus oral decontamination with chlorhexidine and continuous aspiration of subglottic secretions (CASS), were adopted for patients undergoing mechanical ventilation. We evaluated a total of 21,984 patient-days, and a total of 6,052 ventilator-days (ventilator utilization rate of 0.27). We found VAP rates of 1.3 and 2.0 per 1,000 ventilator days respectively in 2009 and 2010, achieving zero incidence of VAP several times during 12 months, whenever VAP bundle compliance was over 90%. These results suggest that it is possible to reduce VAP rates to near zero and sustain these rates, but it requires a complex process involving multiple performance measures and interventions that must be permanently monitored.

Intensive Care Units

Humans

Middle Aged

Pneumonia, Ventilator-Associated - prevention & control

Aged, 80 and over

Female

Male

Aged

Infection Control - methods

Details

Title: Subtitle: A program for sustained improvement in preventing ventilator associated pneumonia in an intensive care setting
Creators: Raquel A Caserta - Hospital Israelita Albert Einstein
Alexandre R Marra
Marcelino Souza Durão Jr - Hospital Israelita Albert Einstein
Cláudia Vallone Silva - Hospital Israelita Albert Einstein
Oscar Fernando Pavao dos Santos
Henrique Sutton de Sousa Neves
Michael B Edmond
Karina Tavares Timenetsky - Hospital Israelita Albert Einstein
Resource Type: Journal article
Publication Details: BMC infectious diseases, Vol.12(1), 234
DOI: 10.1186/1471-2334-12-234
PMID: 23020101
PMCID: PMC3521195
NLM abbreviation: BMC Infect Dis
ISSN: 1471-2334
eISSN: 1471-2334
Publisher: England
Language: English
Date published: 09/29/2012
Academic Unit: Internal Medicine
Record Identifier: 9983905529302771

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