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Is there a benefit to multidisciplinary rounds in an open trauma intensive care unit regarding ventilator-associated

Van Johnson1, Alicia Mangram, Christopher Mitchell

  • 1Department of Surgery, Methodist Hospitals, Dallas, Texas 75203, USA. vanjohnson@mhd.com

The American Surgeon
|December 17, 2009
PubMed

Insights

Multidisciplinary rounds (MDRs) significantly reduced ventilator-associated pneumonia (VAP) in trauma patients. This collaborative approach in intensive care units (ICUs) improved patient outcomes by decreasing VAP incidence.

Area of Science:

  • Critical Care Medicine
  • Infectious Disease Prevention
  • Trauma Surgery

Background:

  • Before June 2005, patient care in open intensive care units (ICUs) was managed by individual practitioners.
  • Multidisciplinary rounds (MDRs), involving a team of healthcare professionals, were implemented in June 2005 to enhance patient care.
  • Ventilator-associated pneumonia (VAP) is a significant concern in critically ill trauma patients.

Purpose of the Study:

  • To evaluate the impact of implementing Multidisciplinary Rounds (MDRs) on the incidence of ventilator-associated pneumonia (VAP) in trauma patients.
  • To compare VAP rates before and after the institution of MDRs in an open ICU setting.
  • To determine if MDRs lead to a significant reduction in VAP among trauma patients.

Main Methods:

  • A retrospective study design comparing two groups of trauma patients admitted to an open ICU.
  • Group 1: Patients treated from June 2003 to May 2005 (before MDRs).
  • Group 2: Patients treated from June 2005 to May 2007 (after MDRs were implemented).
  • Data collected included ventilator days and the incidence of VAP. Patient severity was controlled using Injury Severity Score (ISS) and Abbreviated Injury Score (AIS).

Main Results:

  • The incidence of VAP per thousand ventilator days decreased from 34.4 in Group 1 to 23.4 in Group 2.
  • A statistically significant reduction in VAP was observed (P = 0.04).
  • The implementation of MDRs was associated with a significant decrease in VAP incidence in trauma patients, even when controlling for injury severity.

Conclusions:

  • Multidisciplinary rounds (MDRs) are an effective strategy for reducing ventilator-associated pneumonia (VAP) in trauma patients within open ICUs.
  • Collaborative patient care through MDRs contributes to improved infection control and patient outcomes.
  • The findings support the integration of MDRs as a standard practice in critical care for trauma populations.

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