Is there a benefit to multidisciplinary rounds in an open trauma intensive care unit regarding ventilator-associated pneumonia?
Multidisciplinary rounds (MDRs) have been instituted for patient care since June 2005. Before June 2005, all care was provided by individual practitioners. MDRs include the surgical intensivist, surgical resident, patient's nurse, case manager, pharmacist, chaplain, nutritionist, and respiratory therapist. Our study examined the effect of MDRs on ventilator-associated pneumonia in trauma patients in open intensive care units (ICUs). Group 1 included patients from June 2003 to May 2005 before the implementation of MDRs, and Group 2 included patients after the institution of MDRs from June 2005 to May 2007. In Group 1, there were 83 ventilator-associated pneumonias (VAPs) during 2414 ventilator days. In Group 2, there were 49 VAPs during 2094 ventilator days. The ratio of VAPs per thousand ventilator days decreased from 34.4 to 23.4 between the two groups (P = 0.04). When comparing trauma patients in our open ICU with similar mean Injury Severity Score and mean Abbreviated Injury Score for chest and for head and neck, implementing MDRs significantly decreased our incidence of VAP.
Johnson
Van
V
Department of Surgery, Methodist Hospitals, Dallas, Texas 75203, USA. vanjohnson@mhd.com
Mangram
Alicia
A
Mitchell
Christopher
C
Lorenzo
Manuel
M
Howard
Dot
D
Dunn
Ernest
E
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000458:organization & administration*; D033183:Interdisciplinary Communication; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D056164:Teaching Rounds / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000628:therapy