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Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit

Sean M Berenholtz1, Julius C Pham, David A Thompson

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. sberenho@jhmi.edu

Infection Control and Hospital Epidemiology
|April 5, 2011
PubMed
Abstract

Insights

A multifaceted intervention significantly improved adherence to evidence-based therapies, leading to a sustained reduction in ventilator-associated pneumonia (VAP) rates in intensive care units.

Area of Science:

  • Critical Care Medicine
  • Infectious Disease Prevention
  • Healthcare Quality Improvement

Background:

  • Ventilator-associated pneumonia (VAP) is a significant complication in mechanically ventilated patients.
  • Compliance with evidence-based therapies is crucial for VAP prevention.
  • Existing VAP rates necessitate effective intervention strategies.

Purpose of the Study:

  • To assess the impact of a multifaceted intervention on compliance with evidence-based therapies.
  • To evaluate the effect of this intervention on VAP incidence rates.
  • To determine the sustainability of VAP reduction over time.

Main Methods:

  • A collaborative before-after cohort study was conducted in 112 intensive care units.
  • A multifaceted intervention focused on 5 evidence-based recommendations for VAP prevention was implemented.
  • Data on VAP cases and ventilator-days were collected for 30 months post-intervention.

Main Results:

  • Overall VAP rates decreased from a median of 5.5 cases per 1,000 ventilator-days at baseline to 0 cases at 16-18 months and 28-30 months post-intervention (P < .001).
  • Compliance with evidence-based therapies increased from 32% to 84% during the study period (P < .001).
  • A sustained reduction in VAP rates of up to 71% was observed.

Conclusions:

  • A multifaceted intervention effectively increased adherence to evidence-based therapies.
  • The intervention led to a substantial and sustained decrease in VAP rates.
  • This approach demonstrates a successful strategy for VAP prevention in ICUs.

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