Ventilator-associated pneumonia: caveats for benchmarking

Tulleken, Jaap; Zijlstra, Jan G.; Ligtenberg, Jack J. M.; Spanjersberg, Rob; Werf, Tjip S. van der

doi:10.1007/s00134-004-2247-z

Cited by 26 publications

(2 citation statements)

References 4 publications

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“…VAP incidence described as episodes per 1000 patient-days may underestimate the incidence expressed as episodes per 1000 ventilator-days by almost 40%, thus demonstrating that the method of reporting VAP rates has a significant impact on risk estimates [7]. Accordingly, clinicians in charge of patientcare policies should be aware of how to read and compare VAP rates [53]. Provided that the sample size is sufficient, problems related to statistics would be simple to overcome by consensus.…”

Section: Statisticsmentioning

confidence: 99%

Ventilator-Associated Pneumonia as a Quality Indicator for Patient Safety?

Uçkay

Ahmed

Sax

et al. 2008

Clinical Infectious Diseases

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The economic and clinical burden of ventilator-associated pneumonia (VAP) is uncontested. In many hospitals, VAP surveillance is conducted to identify outbreaks and to monitor infection rates. Here, we discuss the concept of benchmarking in health care as modeled on industry, and we contribute personal arguments against considering the VAP rate as a potential candidate for benchmarking or for monitoring the quality of patient care. Accurate benchmarking of VAP rates currently seems to be unfeasible, because the patient case mix is often too diverse and complicated to be adjusted for, and diagnostic criteria and surveillance protocols vary. Thus, the risk of drawing inaccurate comparisons is high. In contrast, some risk factors for VAP are modifiable and can be monitored and used as quality indicators. Process-oriented surveillance permits bypass of case-mix and diagnostic constraints. A well-defined interhospital surveillance system is necessary to prove that interventions on procedures do really lead to a reduction of VAP rates.

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Section: Statisticsmentioning

confidence: 99%

Ventilator-Associated Pneumonia as a Quality Indicator for Patient Safety?

Uçkay

Ahmed

Sax

et al. 2008

Clinical Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Definition of VAP was based on the recommendations of the Centers for Disease Control and Prevention [4]. Overall, out of 550 patients ventilated for >48 hours, only two cases of definite VAP were observed [5]. Because no further improvement could be achieved in this field, we turned our attention to other outcome parameters.…”

mentioning

confidence: 99%