Ventilator-associated pneumonia and the importance of education of ICU nurses on prevention - Preliminary results.

Abstract

Background and aimsVentilator-associated pneumonia (VAP) increases intensive care unit (ICU) length of stay, ICU mortality, the number of ventilator days, and costs. We implemented a VAP bundle and investigated its efficacy on prevention. Materials and methodsA prospective observational study was conducted between January 1, 2015 and December 31, 2015 in a 12-bed multidisciplinary ICU. The bundle was implemented on July 02, 2015. Comparative analysis was performed before and after the implementation of the bundle. The compliance of the nurses was also studied. ResultsThe incidence of VAP was 21.5/1,000 ventilator days (95% CI: 14.17–31.10) in the first phase and 12.0/1,000 ventilator days (95% CI: 7.2–19.49) in the second phase. Relative risk reduction was 44% (95% CI: −0.5 to 0.98). Most common bacteria identified during the first phase were Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Staphylococcus aureus; and in the second phase P. aeruginosa, Acinetobacter baumannii, and S. maltophilia were identified. Significant improvement was achieved in the head-of-bed elevation (p = 0.004), oral care (p = 0.01), hand hygiene (p < 0.001), endotracheal suctioning (p = 0.004), and removal of condensate (p = 0.043). DiscussionThe incidence of VAP showed tendency for reduction. The prevalence of nursing-dependent bacteria decreased and compliance in following prevention methods increased.ConclusionThese results underline the importance of education of prevention methods.