Major articleDecreasing ventilator-associated pneumonia in adult intensive care units using the Institute for Healthcare Improvement bundle
Section snippets
Methods
This study was conducted in the 18-bed adult ICU including the medical, surgical, and coronary care units at Dhahran Health Center, a 350-bed hospital in Eastern Saudi Arabia. Dhahran Health Center has 5 ICUs (cardiac, medical, surgical, pediatric, and neonatal). The study was conducted at the adult ICUs.
Results
Adherence with all the elements of the VAP bundle improved from 20% in the first 3 months to 82% in the final 3 months of the intervention. There were 29 VAP events (9.3 events/1000 ventilator-days) during the 12-month period from January 2006 through December 2006 compared with 10 VAP events (3 events/1000 ventilator-days) in 2007 and 9 VAP events (2.1 events/1000 ventilator-days) in 2008 (Fig 1). Thus, the annual average VAP rate in the postintervention period was 2.5/1000 ventilator-days.
Discussion
In the current study, we adopted the IHI VAP bundle that resulted in a significant decrease in the VAP rate and maintained such a reduction over 24 months. In Saudi Arabia, 2 previous studies were conducted to decrease the VAP rate.5, 13 In a prospective randomized study in a tertiary care ICU, authors compared the incidence of VAP using the heat and moisture exchanger versus the heated humidifying system. They found no significant difference in the incidence of VAP between the 2 systems in
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The authors thank the Saudi Aramco Medical Services Organization (SAMSO) facilities for the research data utilized in this paper. Opinions expressed in this article are those of the authors and not necessarily of SAMSO.
Conflicts of interest: None to report.