DES PLAINES, Ill. -- A dramatic decrease in the incidence of a dreaded complication affecting ventilator-dependent patients in the intensive care unit occurred following implementation of an education program to teach nursing and respiratory therapy staffs about improved techniques, according to the authors of a study published in the November issue of Critical Care Medicine.
"Educating healthcare workers who care for mechanically ventilated patients can decrease the rate of ventilator-associated pneumonia," said Jeanne E. Zack, BSN, Washington University School of Medicine, Department of Hospital Epidemiology and Infection Control, co-author of the study. "Focusing healthcare workers on this educational program is important to maximize patient safety and provide the highest quality of care to our sickest patients."
Ventilator-associated pneumonia is the most common hospital-acquired infection among patients who need mechanical ventilation, and can result in excessive deaths, prolonged lengths of hospitalization and increased medical care costs.
Members of the Barnes-Jewish Hospital infection control team followed all patients admitted to the intensive care units between October 1, 1999 and September 30, 2001 and surveyed for the occurrence of ventilator-associated pneumonia. The results of the survey showed 191 episodes of ventilator-associated pneumonia occurred in 15,094 ventilator days (12.6 per 1000 ventilator days) in the 12 months before the education program. Following the program, the rate of ventilator-associated pneumonia decreased to 81 episodes in 14,171 ventilator days, a decline of 57.6%. In addition to reducing pneumonia, the program also resulted in cost savings estimated to be between $425,606 and $4.05 million.
The education program, developed by a multidisciplinary task force, consisted of a 10-page study module on risk factors and practice modifications involved in ventilator-associated pneumonia, training at staff meetings, and formal lectures. Fact sheets and posters reinforcing the information were posted throughout the intensive care units and the department of respiratory care services. The education program was directed at respiratory care practitioners who care for the mechanically ventilated patients and intensive care unit nursing staff.
Preventing hospital-acquired infections, including ventilator-associated pneumonia, is an important management objective for reducing hospital infections. Many studies suggest strategies for the prevention of ventilator- associated pneumonia but many of these interventions are not widely implemented in intensive care units. The most common reason for not following the recommendations was the disagreement with the interpretation of clinical trials, the unavailability of resources, and the costs associated with the implementation of specific interventions.
Critical Care Medicine is the official journal of the Society of Critical Care Medicine. It is the premier peer-reviewed, scientific publication in critical care medicine. Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.