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Researchers from Fortis Hospital in Mohali, India conducted a study to investigate a high rate of ventilator-associated pneumonia (VAP) -- 18.3 per 1,000 ventilator days in 2008 and 8.6 per 1,000 ventilator days in 2009 -- in an intensive care unit (ICU). Mandal and Sharma report that reduction of VAP through the implementation of ventilator care bundles was taken as one of the quality improvement initiative for the unit.
The study was divided into pre-intervention, intervention and post-intervention phases. Data was collected on the VAP rates, hand hygiene and ventilator-care bundle practices of the team during pre-intervention and post-intervention phase through knowledge surveys and observational surveys of the team. A workshop on care bundles supported by introduction of an insertion and maintenance tool for ventilators and oral care were the interventions adopted.
Mandal and Sharma report that the surveillance of the ventilator bundle showed an improvement of 64 percent in the post-intervention phase as compared to zero percent in the pre-intervention phase. The VAP rates in 2010 after the introduction of the bundle toward the end of 2009 were observed to be significantly lower than those in 2008 and 2009. The average VAP rates over 12 months dropped from 8.6 per 1,000 ventilator days in 2009 to 2.1 per 1,000 ventilator days in 2010.
The researchers add that supporting activities such as oral care, cleaning and disinfection of ventilator parts were improved upon simultaneously and played a role in the reduced VAP rates. Their research was presented at the International Conference on Prevention & Infection Control (ICPIC) held in Geneva, Switzerland June 29-July 2, 2011.
Reference: AK Mandal and A Sharma. Implementation of a ventilator care bundle to reduce the incidence of ventilator-acquired pneumonia. Presentation at the International Conference on Prevention & Infection Control (ICPIC). BMC Proceedings 2011, 5(Suppl 6):P71doi:10.1186/1753-6561-5-S6-P71