- Poster presentation
- Open access
- Published:
Prevention of ventilator-associated pneumonia in the surgical ICU at Siriraj Hospital
Critical Care volume 17, Article number: P498 (2013)
Introduction
VAP has continued to be a major cause of morbidity and mortality in critically ill patients in Thailand for decades. Previous research found that the implementation of VAP care bundles and the educational program can reduce VAP incidence in the ICU [1]. In this research we aimed to observe the reduction of VAP incidence after the implementation of VAP care bundles to ICU medical personnel.
Methods
Inclusion criteria: all adult surgical patients (>18 years old) who are on ventilatory support in the surgical ICU at Siriraj Hospital. There are two groups, divided into pre-educational group (group I) and post-educational group (group II) (n = 220/group). We also observed the adherence rate to VAP care bundles according to the educational program. The pretest and post-test to determine the efficacy of the educational program were done. The VAP care bundles consisted of weaning according to weaning protocol, sedation vacation, head-of-bed elevation, measurement of cuff pressures four times/day, 2% chlorhexidine use for mouth care and emptying of ventilator circuit condensate.
Results
There were 45.38 and 25.25 episodes of VAP per 1,000 ventilator-days in group I and group II, respectively (P = 0.020). The incidence of VAP was 21.82% in group I and 9.09% in group II (P = 0.000). There was significant reduction in the length of ventilatory support per person (group I = 2, group II = 1 (median), P = 0.013, 95% CI = 0.319 to 0.936) and mortality rate (group I = 15.5%, group II = 8.2%, P = 0.017). There was no significant difference in LOI, LOH and ATB cost. The pretest scores were 15.53 and 17.53 on average from 40 medical personnel in group I and group II, respectively (P = 0.000). The head-of-bed elevation adherence rate was improved after the educational program (group I = 50.1%, group II = 70.36%, P = 0.017). But the adherence to other bundles was not improved. See Tables 1 and 2.
Conclusion
The educational program and the implementation of VAP care bundles can reduce the incidence of VAP, length of ventilatory support and mortality rate in the ICU.
References
Apisarnthanarak A, Pinitchai U, Thongphubeth K, Yeukyen C, Warren DK, Zack JE, et al.: Effectiveness of an educational program to reduce ventilator-associated pneumonia in a tertiary care center in Thailand: a 4-year study. Clin Infect Dis 2007, 45: 704-711. 10.1086/520987
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Pisitsak, C., Chaiwat, O. Prevention of ventilator-associated pneumonia in the surgical ICU at Siriraj Hospital. Crit Care 17 (Suppl 2), P498 (2013). https://doi.org/10.1186/cc12436
Published:
DOI: https://doi.org/10.1186/cc12436