Effect of an education program on the prevention of ventilator-associated pneumonia: A multicenter study.
OBJECTIVE
To evaluate the effect of an educational program targeted on modifiable risk factors on ventilator-associated pneumonia (VAP) rates.


METHODS
After a preliminary study on VAP risk factors was conducted at one teaching hospital, a pre- and post-interventional study was then performed on 12 hospitals in Thailand from January 1, 2002 to June 30, 2003. Each hospital randomly selected 20 patients, who were on mechanical ventilation to be enrolled The study was divided into two phases; 1) pre-intervention, 2) post-intervention. Data collected included patients 'demography and risk factors for VAP During pre-interventional phase, data on risk factors for VAP was analyzed and fedback to healthcare providers in the wards by an infection control nurse (ICN) of the individual hospital. An educational programme on the prevention of VAP was introduced by the ICN. Ventilator-associated pneumonia rates and their risk factors were continuously monitored during the post-interventionl phase.


RESULTS
Two hundred and forty four patients in the pre-interventional phase and 254 patients in the post-interventional phase were included. There was no significant difference in the demography between these two patient populations. After the intervetion, there was a significant improvement in hand-hygiene practices (p<0.001) among healthcare providers and increased use of sucralfate (p=0.05) for stress ulcer prophylaxis. Ventilation-associated pneumonia rate (40.5% vs. 24%; p<0.001) and crude mortality rate associated with VAP (12.3% vs. 8.7%; p<0.001) were also reduced


CONCLUSIONS
The educational programme targeted on modifiable risk factors for prevention of VAP was effective and should be considered as an intervention to reduce VAP rates in developing countries.
Danchaivijitr
Somwang
S
Division of Infectious Diseases, Department of Medicine Siriraj Hospital, Mahidol University, Bangkok. sisdc@mahidol.ac.th
Assanasen
Susan
S
Apisarnthanarak
Anucha
A
Judaeng
Tepnimitr
T
Pumsuwan
Varaporn
V
D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000379:methods*; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital / Q000193:education*; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology*; D015397:Program Evaluation; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors