| Learning Objective #1: describe the evidence-based approaches to reduce the ventilator-associated pneumonia | |||
| Learning Objective #2: Understand the benefic of the target surveillance |
Background: Ventilator-associated pneumonia (VAP) rates in the medical-surgical intensive care unit exceeded the 90th percentile in the year 2001 and 2002 and were significantly higher than those reported in the National Nosocomial Infections Surveillance System (NNIS). In response to these high rates, the Infection Control Committee, Ramathibodi Hospital,Thailand, developed a protocol based on research to prevent VAP for a medical–surgical intensive care unit. Objectives: To reduce the incidence of VAP in the Medical-Surgical Intensive Care Unit. Methods: A prospective cohort study was conducted at the medical–surgical intensive care unit from January 1, 2003 to December 31, 2003. Infection rates were calculated using the NNIS definition. In addition, an incidence density rate was determined, with a denominator of 1000 ventilator-days and were compared using Epi-info. The US-CDC guidelines for prevention of nosocomial pneumonia were used as reference to develop the protocol. Procedures were reviewed by the Infection Control Nurses and the Critical Care Teams. Result: In 2001 and 2002, the means of VAP were 14.91 and 17.47/1000 ventilator-days, respectively. After the implementation of new protocols, there were seven episodes of VAP in 1791 ventilator-days. The mean VAP rate was 3.91/1000 ventilator-days, and has been below the pooled mean data of the NNIS. Using Pearson' s Chi-square analysis, the incidence of VAP was significantly less than in 2003 than in 2001 and 2002. Conclusion: This study illustrates that the collaboration among health care professions using evidence-based approaches can reduce the VAP rate.
Key Words: Ventilator-associated pneumonia/Infection control/Evidence-based approaches
* Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, THAILAND ** Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, THAILAND