Survey Shows Low Compliance with VAP Prevention Practices as Reported by ICU Physicians


On average, 7 percent of patients admitted to intensive-care units (ICUs) suffer from a potentially preventable ventilator-associated pneumonia (VAP). Lambert, et al. (2013) surveyed for attitudes and practices of ICU physicians in the field of VAP prevention.
A questionnaire was made available online in six languages from April 1, 2012 to Sept. 1, 2012 and disseminated through international and national ICU societies. The researchers investigated reported practices with regard to established clinical guidelines for VAP prevention, and measurement of process and outcomes, under the assumption "if you cannot measure it, you cannot improve it"; as well as attitudes toward the implementation of a measurement system.

Weighted estimations for Europe were computed based on countries for which at least 10 completed replies were available, using total country population as a weight. Data from other countries were pooled together. 

A total of 1730 replies were received from 77 countries; 1281 from 16 countries were used to compute weighted European estimates, as follows: care for intubated patients, combined with a measure of compliance to this guideline at least once a year, was reported by 57 percent of the respondents (95% CI: 54-60) for hand hygiene, 28 percent (95% CI: 24-33) for systematic daily interruption of sedation and weaning protocol, and 27 percent (95%: 23-30) for oral care with chlorhexidine.

Only 20 percent (95% CI: 17-22) were able to provide an estimation of outcome data (VAP rate) in their ICU, still 93 percent (95% CI: 91-94) agreed that "monitoring of VAP-related measures stimulates quality improvement." Results for 449 respondents from 61 countries not included in the European estimates are broadly comparable.
The researchers say their study shows a low compliance with VAP prevention practices, as reported by ICU doctors in Europe and elsewhere, and identifies priorities for improvement. Their research was published in Antimicrobial Resistance and Infection Control.

Reference: Lambert ML, et al.  Prevention of ventilator-associated pneumonia in intensive care units: an international online survey. Antimicrobial Resistance and Infection Control 2013, 2:9 doi:10.1186/2047-2994-2-9

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