title: Reducing ventilator-associated pneumonia rates through a staff education programme.
abstract: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in patients on mechanical ventilation and results in increases in mortality, prolonged hospitalization and costs. Preventive measures for VAP are well-documented and evidence-based, yet remain poorly implemented in most intensive care units. We undertook an observational pre and post-intervention study to assess whether an educational programme focusing on preventive practices for VAP could reduce the incidence. Six hundred and seventy-seven adult patients, mechanically ventilated for >48 h were included in the study population. An evidence-based guideline for preventive practices at the bedside was developed and disseminated to the intensive care unit staff. VAP incidence rates before and after implementation of the educational programme were compared. VAP infection rates reduced by 51%, from a mean of 13.2+/-1.2 in the pre-intervention period to 6.5+/-1.5/1000 device days in the post-intervention period (mean difference 6.7; 95% CI: 2.9-10.4, P =0.02). A multidisciplinary educational programme geared towards intensive care unit staff can successfully reduce the incidence rates of VAP. Further studies will be needed to assess the impact on broader outcome measures such as costs or mortality.
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan. nawal.salahuddin@aku.edu
authors.forename: N
authors.initials: N
authors.lastname: Salahuddin
authors.forename: A
authors.initials: A
authors.lastname: Zafar
authors.forename: L
authors.initials: L
authors.lastname: Sukhyani
authors.forename: S
authors.initials: S
authors.lastname: Rahim
authors.forename: M F
authors.initials: MF
authors.lastname: Noor
authors.forename: K
authors.initials: K
authors.lastname: Hussain
authors.forename: S
authors.initials: S
authors.lastname: Siddiqui
authors.forename: M
authors.initials: M
authors.lastname: Islam
authors.forename: S J
authors.initials: SJ
authors.lastname: Husain
mesh_terms: D000328:Adult; D019985:Benchmarking; D002983:Clinical Competence / Q000592:standards; D003299:Cooperative Behavior; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004866:Equipment Contamination; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods* / Q000592:standards; D016357:Infection Control Practitioners / Q000523:psychology; D007318:Inservice Training / Q000458:organization & administration*; D007400:Interprofessional Relations; D007902:Length of Stay; D010154:Pakistan / Q000453:epidemiology; D010348:Patient Care Team; D010564:Personnel, Hospital / Q000193:education* / Q000523:psychology; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012121:Respiration, Artificial / Q000009:adverse effects*