Brief ReportEfficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit
Section snippets
Setting
This study was conducted in the 18-bed adult MICU at St Joseph's Regional Medical Center, a 750-bed teaching hospital in northern New Jersey, which admitted a median of 15,277 adult patients (range, 15,133 to 15,538) during the years of this study. Between January 1, 2003 and December 31, 2007, the MICU admitted a median of 1056 patients/year (interquartile range [IQR] = 1001 to 1133), of whom roughly 35% underwent mechanical ventilation. All patients were age ≥ 18 years, with no upper age
Results
We used 2 approaches to examine the change in the rate of VAP before and after intervention. First, we compared the overall rate during the historical period with the rate for the postintervention observation period. These data, shown in Figure 1, demonstrate a statistically significant (P = .006) decrease from a median value of 14.1 cases/103 ventilator-days (IQR = 12.1 to 20.6; 95% confidence interval [CI] = 10.9 to 20.3) to a median of 0 cases/103 ventilator-days (IQR = 0 to 1.1; 95% CI = 0
Discussion
Spurred in part by the Institute for Healthcare Improvement's “100,000 Lives Campaign,” the medical community undertook the development of practice guidelines to improve outcomes related to a core group of preventable clinical conditions. Among these, VAP has attracted considerable attention, with the publication of at least 15 randomized controlled trials and 7 integrative systematic reviews and meta-analyses directed toward the goal of preventing this complication.9, 10
Fox11 has proposed a
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Cited by (63)
The Impact of Initiation of an Intensivist-Led Patient Management Protocol on Outcomes After Cardiac Surgery
2021, Journal of Cardiothoracic and Vascular AnesthesiaAssessment of the effectiveness of a ventilator associated pneumonia prevention bundle that contains endotracheal tube with subglottic drainage and cuff pressure monitorization
2017, Brazilian Journal of Infectious DiseasesCitation Excerpt :Prevention of VAP has become the priority of ICUs all around the world, and in America in particular.11–13 Since 2005, the rate of VAP had a significant decline as a result of the implementation of VAP prevention bundles.9,13–16 Reduction of VAP as a result of prevention efforts have been reported as 1–4/1000 ventilator days.2
Impact and feasibility of an emergency department–based ventilator-associated pneumonia bundle for patients intubated in an academic emergency department
2017, American Journal of Infection ControlPrevention of ventilator-associated pneumonia: Use of the care bundle approach
2016, American Journal of Infection ControlVentilator-Associated Pneumonia
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth Edition
Disclosures: none.