Volume 11 Supplement 2

27th International Symposium on Intensive Care and Emergency Medicine

Open Access

Decreasing the incidence of ventilator-associated pneumonia using the FAST-HUG evaluation

  • T Papadimos1,
  • S Hensley1 and
  • J Duggan1
Critical Care200711(Suppl 2):P433

DOI: 10.1186/cc5593

Published: 22 March 2007

Introduction

Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in critically ill patients. We implemented a performance improvement project over 2 years to reduce VAP incidence in the medical ICU (MICU) and surgical ICU (SICU).

Methods

From 1 January 2004 to 31 December 2005 a prospective intervention was undertaken. Results were compared with historic controls (2003). In year 1 we introduced aggressive oral care using chlorhexidine mouthwash, an early extubation strategy, changing respiratory equipment only when visibly soiled or malfunctioning, and aggressive enforcement of hand-washing and barrier protection methods. At the end of year 1 we augmented the project with the addition of the FAST-HUG (feeding, analgesia, sedation, thromboembolic prevention, head of bed elevation, ulcer prophylaxis, and glucose control) evaluation. During year 2 FAST-HUG was emphasized daily on patient rounds by the intensivists. The CDC VAP definition was used; the Friedman test and Wilcoxon signed ranks test were used for data analysis.

Results

The VAP rates in the MICU and SICU for the control period, 1 January–31 December 2003, were 13.41 and 19.37 VAPs/1,000 ventilator-days, respectively. The MICU VAP rate declined to 3.02 VAPs/1,000 ventilator-days and the SICU rate declined to 8.16 VAPs/1,000 ventilator-days over 2 years. The greatest declines occurred during year 2 (Table 1).
Table 1

abstract

 

2003

2004

2005

P values

MICU

13.41

10.14

3.02

NSa, <0.05b,c

SICU

19.37

16.45

8.16

NSa, <0.05b,c

NS, not significant. a2003/04. b2004/05. c2003/05.

Conclusion

Daily FAST-HUG review on ICU rounds, with aggressive oral care, an early extubation strategy, and aggressive infection control practices, decreases VAP rates.

Authors’ Affiliations

(1)
University of Toledo College of Medicine

Copyright

© BioMed Central Ltd. 2007

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