Ventilator-associated pneumonia and the importance of education of ICU nurses on prevention - Preliminary results.
OBJECTIVE
Ventilator-associated pneumonia (VAP) increases intensive care unit (ICU) length of stay, ICU mortality, the number of ventilator days, and costs. We implemented a VAP bundle and investigated its efficacy on prevention.


METHODS
A prospective observational study was conducted between January 1, 2015 and December 31, 2015 in a 12-bed multidisciplinary ICU. The bundle was implemented on July 02, 2015. Comparative analysis was performed before and after the implementation of the bundle. The compliance of the nurses was also studied.


RESULTS
The incidence of VAP was 21.5/1,000 ventilator days (95% CI: 14.17-31.10) in the first phase and 12.0/1,000 ventilator days (95% CI: 7.2-19.49) in the second phase. Relative risk reduction was 44% (95% CI: -0.5 to 0.98). Most common bacteria identified during the first phase werePseudomonas aeruginosa,Stenotrophomonas maltophilia, andStaphylococcus aureus; and in the second phaseP. aeruginosa,Acinetobacter baumannii, andS. maltophiliawere identified. Significant improvement was achieved in the head-of-bed elevation (p= 0.004), oral care (p= 0.01), hand hygiene (p< 0.001), endotracheal suctioning (p= 0.004), and removal of condensate (p= 0.043).


CONCLUSIONS
The incidence of VAP showed tendency for reduction. The prevalence of nursing-dependent bacteria decreased and compliance in following prevention methods increased.


CONCLUSIONS
These results underline the importance of education of prevention methods.
Department of Anaesthesiology and Intensive Therapy, Semmelweis University , Budapest, Hungary.
Bence
B
Mogyoródi
Department of Anaesthesiology and Intensive Therapy, Semmelweis University , Budapest, Hungary.
Erzsébet
E
Dunai
Department of Anaesthesiology and Intensive Therapy, Semmelweis University , Budapest, Hungary.
János
J
Gál
Department of Anaesthesiology and Intensive Therapy, Semmelweis University , Budapest, Hungary.
Zsolt
Z
Iványi
bundle; education; hospital-acquired infection; prevention; ventilator-associated pneumonia