Adherence to ventilator-associated pneumonia bundle and incidence of ventilator-associated pneumonia in the surgical intensive care unit.

Journal Article

OBJECTIVE: To examine the impact of adherence to a ventilator-associated pneumonia (VAP) bundle on the incidence of VAP in our surgical intensive care units (SICUs). DESIGN: Prospectively collected data were retrospectively examined from our Infection Control Committee surveillance database of SICU patients over a 38-month period. Cost of VAP was estimated at $30,000 per patient stay. SETTING: Two SICUs at a tertiary care academic level I trauma center. PATIENTS: Ventilated patients admitted to a SICU. INTERVENTION: The Institute for Healthcare Improvement VAP bundle was instituted at the beginning of the study and included head-of-bed elevation, extubation assessment, sedation break, peptic ulcer prophylaxis, and deep vein thrombosis prophylaxis. A daily checklist was considered compliant if all 5 items were performed for each patient. MAIN OUTCOME MEASURES: Patients were assessed for VAP. Staff were assessed for compliance with the VAP bundle. RESULTS: Prior to initiation of the bundle, VAP was seen at a rate of 10.2 cases/1000 ventilator days. Compliance with the VAP bundle increased over the study period from 53% and 63% to 91% and 81% in each respective SICU. The rate of VAP decreased to 3.4 cases/1000 ventilator days. A cost savings of $1.08 million was estimated. CONCLUSIONS: Initiation of the VAP bundle is associated with a significantly reduced incidence of VAP in patients in the SICU and with cost savings. Initiation of a VAP bundle protocol is an effective method for VAP reduction when compliance is maintained.

Full Text

Duke Authors

Cited Authors

  • Bird, D; Zambuto, A; O'Donnell, C; Silva, J; Korn, C; Burke, R; Burke, P; Agarwal, S

Published Date

  • May 2010

Published In

Volume / Issue

  • 145 / 5

Start / End Page

  • 465 - 470

PubMed ID

  • 20479345

Electronic International Standard Serial Number (EISSN)

  • 1538-3644

International Standard Serial Number (ISSN)

  • 0004-0010

Digital Object Identifier (DOI)

  • 10.1001/archsurg.2010.69

Language

  • eng