Reduction in the incidence of poststroke nosocomial pneumonia by using the "turn-mob" program.
BACKGROUND
One of the most common complications in patients with acute ischemic stroke (AIS) is pneumonia, a complication that has an impact on the patient's survival. The purpose of this study was to establish whether the implementation of a passive turning and mobilization program can prevent the occurrence of nosocomial pneumonia (NP) in patients with AIS.


METHODS
We conducted a randomized clinical trial. Patients diagnosed with AIS within the last 48 hours and without mechanical ventilation were included. Group A was the "turn-mob" program: turning and passive mobilization carried out by a previously trained relative. Group B was the control group: standard treatment characterized by turning carried out by the nursing staff. The purpose was to demonstrate whether the implementation of a manual turning and passive mobilization program could reduce the incidence of NP in patients with AIS during their stay at the hospital and up to 14 days after discharge.


RESULTS
In all, 223 patients were included (group A, n = 111; group B, n = 112). Fourteen (12.6%) patients in group A and 30 (26.8%) in group B developed NP. The implementation of the turn-mob program was associated with a decrease in NP, with a relative risk of 0.39 (95% confidence interval .19-.79; P = .008).


CONCLUSIONS
The turn-mob program applied on patients during the acute phase of an ischemic stroke decreases the incidence of NP.
Cuesy
Pilar Grajales
PG
Clinical Epidemiology Medical Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.
Sotomayor
Pilar Lavielle
PL
Piña
Juan Osvaldo Talavera
JO
D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D056888:Patient Positioning; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D020521:Stroke / Q000150:complications / Q000453:epidemiology; D000071939:Stroke Rehabilitation; D013997:Time Factors