Reducing ventilator-associated pneumonia rates through a staff education programme

Salahuddin, Nawal; Zafar, Afia; Sukhyani, L; Rahim, Shabina; Noor, Mahboob; Hussain, Kashif; Siddiqui, Shahla; Islam, Motiul; Husain, Shahid Javed

doi:10.1016/j.jhin.2004.03.002

Cited by 88 publications

(41 citation statements)

References 19 publications

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“…reported P. aeruginosa as the second common organism, Acinetobacter lwoffii being the first most common. [16] Nevertheless, Gram-negative bacilli were the most common pathogens causing VAP in other studies. [1721]…”

Section: Discussionmentioning

confidence: 98%

“…Although this reduction was not statistically significant, we could achieve a reduction in VAP rate at par with published studies from other countries. [3–616] Nevertheless, Arabi et al . reported a higher VAP rate in developing countries than the NHSN benchmark rates, based on a recent systematic review.…”

Section: Discussionmentioning

confidence: 99%

“…[5] The application of multi-module programmes showing reduction in VAP was brought out in many other studies also. [161819] Zaydfudim et al . reported a reduction in the VAP rate following improved compliance of ventilator bundle measures after the implementation of an electronic dashboard.…”

Section: Discussionmentioning

confidence: 99%

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Alcohol-based hand rub and ventilator-associated pneumonia after elective neurosurgery: An interventional study

Saramma¹,

Krishnakumar²,

Dash³

et al. 2011

Indian Journal of Critical Care Medicine

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Background:Interventional studies on the effect of alcohol-based hand rub on ventilator-associated pneumonia (VAP) among neurosurgical patients are scarce.Aim:To observe the effect of alcohol-based hand rub on tracheobronchial colonization and VAP after elective neurosurgical procedures.Materials and Methods:An interventional study using a “before–after” design in a tertiary care center in Kerala. Two 9-month study periods were compared; between these periods, an infection control protocol incorporating an alcohol-based hand rub was implemented for a period of 3 months and continued thereafter. Consecutive patients who required mechanical ventilation after neurosurgery between January and September 2006 and 2007, respectively, were included. Outcome measures included VAP rate, tracheobronchial colonization rate, profile of microorganisms and patient survival.Results:A total of 352 patients were on mechanical ventilator for a varying period of 1–125 days. The patients in the control and intervention groups were similar with regard to sex, age and type of neurosurgery. Tracheobronchial colonization was seen in 86 (48.6%) of 177 in the control group and 73 (41.7%) of 175 among the intervention group (P = 0.195). The VAP rates in the control and intervention groups were 14.03 and 6.48 per 1000 ventilator days (P = 0.08). The predominant organisms causing VAP and tracheobronchial colonization were Klebsiella and Pseudomonas aeruginosa, respectively, in both groups. Patient survival rates were 87.6% (control) and 92% (intervention).Conclusion:Clinical results indicated a better outcome, showing a reduction in tracheobronchial colonization rate and VAP rate, although this was not statistically significant.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Alcohol-based hand rub and ventilator-associated pneumonia after elective neurosurgery: An interventional study

Saramma¹,

Krishnakumar²,

Dash³

et al. 2011

Indian Journal of Critical Care Medicine

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“…We recommend that training programs and universal precaution protocols be implemented for ICU staff because these measures significantly reduce the incidence of ventilator-associated pneumonias [91], [92], [93], [94], [95], [96], central venous catheter-associated bacteremia [94], [97], [98], [99], [100] and catheter-associated urinary tract infections [101]. …”

Section: Preventionmentioning

confidence: 99%

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

Reinhart

Brunkhorst²,

Bone³

et al. 2010

GMS German Medical Science; 8:Doc14; ISSN 1612-3174

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“…8 Staff education programs for single procedures [9][10][11] or selected bundle of several interventions significantly reduced VAP rate in several studies. [12][13][14][15][16][17][18][19][20][21][22][23][24] Furthermore, staff education and involvement was recommended in several guidelines. 3,5,25 The top management support and availability of supplies were considered crucial for a successful VAP program.…”

Section: Introductionmentioning

confidence: 99%

http://openventio.org/Volume1_Issue1/The_Impact_of_VAP_Staff_Education_on_VAP_Morbidity_and_Mortality_in_Alexandria_University_PRRMOJ_1_105.pdf

EH¹,

AM²,

TH³

et al. 2014

Pulm Res Respir Med Open J

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CitationElmenshawy AM, Elbadawy TH, Abu khaber H, Hafez SF, Fayed AM, Ibrahim EH. The impact of VAP staff education on VAP morbidity and mortality in Alexandria University. ResearchPage 32 ABSTRACT Background: Staff education had several success stories in reducing Ventilator-associated Pneumonia (VAP) rate. However, the stability of supplies and the top management support were not addressed in most of these studies. In addition, both were considered essential in several reviews. Aim: To determine the efficiency (VAP rate) and efficacy (mechanical ventilation morbidity and mortality) of VAP staff education with deficient supplies and lack of top management support. Methods: Quasi-experimental study with before and after prospective cohort in two medical/ surgical ICUs of Alexandria university affiliated hospitals during the period from September 2007 till May 2013. The intervention phase included the provision of supplementary supplies, interactive education for physicians and nurses followed by a VAP campaign. All VAP episodes not only the first one was included. Results: A total of 598 patients were enrolled in the study. The adherence to expanded VAP bundle significantly increased in the post-intervention phase as follows; head of bed elevation (from mean of 40 to 100% with p=0.001), oral care (from mean of 20 to 100% with p=0.001), daily sedation vacation (from mean of 56.5 to 91% with p=0.001), daily assessment of weaning (from mean of 9 to 25% with p=0. 03), peptic ulcer prophylaxis (from mean of 83 to 100% with p=0.001), DVT prophylaxis (from mean of 82 to 100% and p=0.001), cuff pressure measurement (from mean of 9 to 60% with p=0.001), and hand hygiene (from mean of 8 to 28.5% with p=0.001).The VAP rate decreased significantly by 35% (from 66.5 to 43 per 1000 MV days) with p= 0.002 and CI 9.73-37.15 in spite of significant increase of the ventilator utilization ratio (p <0.001) in the post-intervention phase. The MV, antibiotic and ICU days did not change significantly in the post-intervention phase. The distribution of organisms did not differ significantly between both groups (p=0. 465). The sensitivity of most of carbapenems and β-lactam/β-lactamase inhibitors to Acinetobacter, Klebsiella andPseudomonas decreased significantly in the post intervention phase whereas the sensitivity of vancomyicin to Staphylococcus aureus remained the same. Conclusions: In spite of the lack of top management support and fluctuating supplies, VAP staff education was still efficient in reducing VAP without affecting mortality or MV days or ICU length of stay.

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Reducing ventilator-associated pneumonia rates through a staff education programme

Cited by 88 publications

References 19 publications

Alcohol-based hand rub and ventilator-associated pneumonia after elective neurosurgery: An interventional study

Alcohol-based hand rub and ventilator-associated pneumonia after elective neurosurgery: An interventional study

http://openventio.org/Volume1_Issue1/The_Impact_of_VAP_Staff_Education_on_VAP_Morbidity_and_Mortality_in_Alexandria_University_PRRMOJ_1_105.pdf

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