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.

O Impacto Da Aprendizagem Interprofissional Na Pneumonia Associada À Ventilação: Implementação De Bundles Em Uma Unidade De Cuidados Intensivos

“…There was a rate of 88.81% in the post-intervention period for HH before the procedure and 94.88% after. These rates are similar to those reported by Lake Of The Woods District Hospital in Canada with 87.7% of adherence to HH before the intervention and 93.2% after the educational intervention (20) .…”

The Pattern of Antibiotic Resistance of Common Bacteria Causing Nosocomial Infections

“…Obtaining VAP might be not only be via ventilator. Health workers especially nurses have an important role in inhibiting colonization of bacteria by mechanical ventilation (22). In the present study, 3 out of 4 S. aurous isolates were Methicillin-resistant S. aureus (MRSA).…”

Incidence of ventilator-associated pneumonia at ICU - the effect of preventive measures in nursing care

“…The effect of compliance with the complex set of strategic procedures with a demonstrated effect upon a significant decrease of VAP incidence has a great impact upon decreasing the incidence of this disease, as has been confirmed with numerous studies performed at departments of intensive care (Álvarez-Lerma et al, 2014; Oliveira et al, 2014). As an example, it is possible to mention the study performed by Hungarian authors, which showed a decreased incidence of VAP and decreased relative risk of 44% following the introduction of the preventive bundle of measures (Mogyoródi et al, 2016). The basic and simplest measure in VAP prevention is keeping the patient in a semirecumbent position, which has a positive effect upon decreasing the incidence of VAP (Caserta et al, 2012; Dosher et al, 2014; El Azab et al, 2013).…”