Chest
Clinical Investigations in Critical CareAn Educational Intervention to Reduce Ventilator-Associated Pneumonia in an Integrated Health System: A Comparison of Effects
Section snippets
Intervention
A multidisciplinary task force consisting of two physicians (M.H.K. and V.J.F.) and members of the Barnes-Jewish Hospital Infection Control Team was formed in February 1999 to develop a policy for the prevention of ventilator-associated pneumonia. This policy was derived in large part from two literature reviews authored by one of the task force members.7, 8 The task force also compared the new policy to the Centers for Disease Control and Prevention recommendations for the prevention of
Compliance Results
The intervention was introduced in the spring of 2000 at community hospital 1, summer 2000 at community hospital 2, fall 2000 at the adult teaching hospital, and winter 2000 at the pediatric hospital. All hospitals had completed the intervention by the fall of 2000, except the pediatric hospital, which completed the intervention by the end of 2000. The infection control nurse assigned to the individual ICU determined when completion of the intervention had occurred in terms of staff exposure to
DISCUSSION
This study demonstrated that an educational initiative directed at respiratory care practitioners and ICU nurses was associated with decreases in the incidence of ventilator-associated pneumonia at three of four participating hospitals. Decreases in ventilator-associated pneumonia rates ranged from 38 to 61%. Our results suggest that participation by respiratory therapy staff and incorporation of the self-study module into mandatory competency training for staff are important for reducing
ACKNOWLEDGMENT
The authors thank the infection control specialists, respiratory care practitioners, and the nursing staffs participating in this quality improvement project.
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This work was supported by funding from the Centers for Disease Control and Prevention Cooperative Agreement UR8/CCU715087–01, BJC Hospital Epidemiology and Infection Control Consortium, and the National Institutes of Health (GM00709).
The study module and self-examinations can be obtained as a CD-ROM through the Association for Professionals in Infection Control and Epidemiology.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: [email protected]).