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Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patients
Maria Parisi1, Vasiliki Gerovasili2, Stavros Dimopoulos1
1Maria Parisi is a high-dependency unit nurse, Vasiliki Gerovasili is a pulmonologist, Efstathia Kampisiouli is a nursing specialization manager and surgical nurse specialist, Christina Goga is a pulmonologist, Christina Routsi is an associate professor of intensive care medicine, and Serafeim Nanas is a professor of intensive care medicine, First Department of Critical Care, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece.Stavros Dimopoulos is an internal medicine-intensive care medicine specialist, John Farman Intensive Care Unit, Addenbrookes Cambridge University Hospital, Cambridge, United Kingdom.Efstathia Perivolioti is a consultant and Athina Argyropoulou is a consultant and director, Department of Clinical Microbiology, Evangelismos Hospital, Athens, Greece.Sotirios Tsiodras is an associate professor of medicine and infectious diseases, University of Athens Medical School, 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece.
Background:
Ventilator-associated pneumonia (VAP), one of the most common hospital-acquired infections, has a high mortality rate.
Objectives:
To evaluate the incidence of VAP in a multidisciplinary intensive care unit and to examine the effects of the implementation of ventilator bundles and staff education on its incidence.
Methods:
A 24-month-long before/after study was conducted, divided into baseline, intervention, and postintervention periods. VAP incidence and rate, the microbiological profile, duration of mechanical ventilation, and length of stay in the intensive care unit were recorded and compared between the periods.
Results:
Of 1097 patients evaluated, 362 met the inclusion criteria. The baseline VAP rate was 21.6 per 1000 ventilator days. During the postintervention period, it decreased to 11.6 per 1000 ventilator days (P = .01). Length of stay in the intensive care unit decreased from 36 to 27 days (P = .04), and duration of mechanical ventilation decreased from 26 to 21 days (P = .06).
Conclusions:
VAP incidence was high in a general intensive care unit in a Greek hospital. However, implementation of a ventilator bundle and staff education has decreased both VAP incidence and length of stay in the unit.
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