Journal article
Impact of the ventilator bundle on ventilator-associated pneumonia in intensive care unit
International journal for quality in health care : journal of the International Society for Quality in Health Care, Vol.23(5), pp.538-544
08/04/2011
DOI: 10.1093/intqhc/mzr049
PMCID: PMC3168266
PMID: 21821603
Abstract
The ventilator bundle is being promoted to prevent adverse events in ventilated patients including ventilator-associated pneumonia (VAP). We aimed to: (i) examine adoption of the ventilator bundle elements; (ii) determine effectiveness of individual elements and setting characteristics in reducing VAP; (iii) determine effectiveness of two infection-specific elements on reducing VAP; and, (iv) assess crossover effects of complying with VAP elements on central line-associated bloodstream infections. Cross-sectional survey. Four hundred and fifteen ICUs from 250 US hospitals. Managers/directors of infection prevention and control departments. Adoption and compliance with ventilator bundle elements. VAP rates. The mean VAP rate was 2.7/1000 ventilator days. Two-thirds (n = 284) reported presence of the full ventilator bundle policy. However, only 66% (n = 188/284) monitored implementation; of those, 39% (n = 73/188) reported high compliance. Only when an intensive care unit (ICU) had a policy, monitored compliance and achieved high compliance were VAP rates lower. Compliance with individual elements or just one of two infection-related element had no impact on VAP (β = -0.79, P= 0.15). There was an association between complying with two infection elements and lower rates (β = -1.81, P< 0.01). There were no crossover effects. Presence of a full-time hospital epidemiologist (HE) was significantly associated with lower VAP rates (β = -3.62, P< 0.01). The ventilator bundle was frequently present but not well implemented. Individual elements did not appear effective; strict compliance with infection elements was needed. Efforts to prevent VAP may be successful in settings of high levels of compliance with all infection-specific elements and in settings with full-time HEs.
Details
- Title: Subtitle
- Impact of the ventilator bundle on ventilator-associated pneumonia in intensive care unit
- Creators
- Monika Pogorzelska - Columbia University School of Nursing, Mailman School of Public Health, New York, NY 10032, USA. mp2422@columbia.eduPatricia W StoneE Yoko FuruyaEli N PerencevichElaine L LarsonDonald GoldmannAndrew Dick
- Resource Type
- Journal article
- Publication Details
- International journal for quality in health care : journal of the International Society for Quality in Health Care, Vol.23(5), pp.538-544
- Publisher
- England
- DOI
- 10.1093/intqhc/mzr049
- PMID
- 21821603
- PMCID
- PMC3168266
- ISSN
- 1353-4505
- eISSN
- 1464-3677
- Grant note
- R01 NR010107-03 / NINR NIH HHS R01 NR010107-02 / NINR NIH HHS R01 NR010107-04 / NINR NIH HHS P20RR020616 / NCRR NIH HHS R01 NR010107-01A1 / NINR NIH HHS R01 NR010107 / NINR NIH HHS R01NR010107 / NINR NIH HHS
- Language
- English
- Date published
- 08/04/2011
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779495902771
Metrics
15 Record Views