Abstract
BackgroundVentilator-associated pneumonia (VAP) is a common infection in the intensive care unit (ICU) and associated with a high mortality.MethodsA 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.ResultsWe 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%.ConclusionThese 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.
Highlights
Ventilator-associated pneumonia (VAP) is a common infection in the intensive care unit (ICU) and associated with a high mortality
The improvement in outcomes associated with recent initiatives suggest that many cases of VAP can be prevented by adhering to bundles of infection prevention measures [4,5]
We report our observations for the period from October 2008 to December 2010 to evaluate whether the sustained implementation of the VAP bundle in our ICU could effectively reduce the incidence of VAP
Summary
Ventilator-associated pneumonia (VAP) is a common infection in the intensive care unit (ICU) and associated with a high mortality. Ventilator-associated pneumonia (VAP) is a common infection in the ICU. The improvement in outcomes associated with recent initiatives suggest that many cases of VAP can be prevented by adhering to bundles of infection prevention measures [4,5]. Since 2007, we have implemented the VAP bundle in our ICU, including oral hygiene with 0.12% chlorhexidine and continuous aspiration of subglottic secretions (CASS) [4]. With these measures we were able to achieve zero incidence of VAP during a few months when a higher than 95% compliance rate with the VAP bundle was obtained [4]. To date there are no reports of sustained low incidence of VAP [4] (near zero)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
