title: Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia.
abstract: OBJECTIVE
  To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia.
  
  
  METHODS
  A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia.
  
  
  RESULTS
  Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389).
  
  
  CONCLUSIONS
  The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.
authors.affiliation: Faculdade de Fisioterapia, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sachetti
authors.affiliation: Faculdade de Fisioterapia, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
authors.forename: Viviane
authors.initials: V
authors.lastname: Rech
authors.affiliation: Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Alexandre Simões
authors.initials: AS
authors.lastname: Dias
authors.affiliation: Faculdade de Fisioterapia, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
authors.forename: Caroline
authors.initials: C
authors.lastname: Fontana
authors.affiliation: Faculdade de Medicina, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
authors.forename: Gilberto da Luz
authors.initials: Gda L
authors.lastname: Barbosa
authors.affiliation: Setor de Controle de Infecção Hospitalar, Hospital São Vicente de Paulo, Passo Fundo, RS, Brasil.
authors.forename: Dionara
authors.initials: D
authors.lastname: Schlichting
mesh_terms: D057189:Checklist; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D017410:Practice Guidelines as Topic