Influence of non-drug bundle of care on incidence rate of ventilator associated pneumonia

Abstract

Objective To explore the influence of non-drug bundle of care on incidence rate of VAP. Methods Prospective analysis was performed on patients with mechanical ventilation in ICU from January 2015 to December 2016. The patients were assessed daily, monitored for target, and divided into infected group and non-infected group according to incidence of VAP. Relationship between incidence of VAP and measures taken in non-drug bundle of care, with all data statistically analyzed by SPSS 19.0 for windows. Results A total of 1 326 cases were collected in this study, with 109 infected cases and 1 217 non-infected cases. It was shown in related single factor analysis that factors influencing incidence of VAP included mode of tracheal intubation (whether with subglottic secretion drainage or not) , severity of clinical conditions of the patients (APACHEⅡ score >18 points) , time of mechanical ventilation (>7 days) , hand sanitation, the patients' compliance to operations like elevation of bed head (>30°) , oral care, assessment of tracheotomy cuff pressure, monitoring of gastric residual volume, timely dumping of condensed water, and unobstructed subglottic secretion drainage (P<0.05) . It was shown in Logistic regression analysis that mechanical ventilation time was an independent factor affecting incidence of VAP (OR=30.536, P<0.01) . Conclusions According to non-drug bundle of care strategies, daily evaluation should be conducted. Early off-machine and early extubation can reduce incidence of VAP. Key words: Pneumonia, ventilator associated; Non-drug bundle of care strategies; Influencing factors