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Multifaceted Approach Reduces Pneumonia in ICU

Ventilator-associated pneumonia rates fall in ICU after intervention improves guideline compliance

MONDAY, March 21 (HealthDay News) -- Rates of ventilator-associated pneumonia (VAP) can be significantly reduced with the implementation of multifaceted intervention aimed at increasing the use of evidence-based therapies in the intensive care unit (ICU), according to a study published in the April issue of Infection Control and Hospital Epidemiology.

Sean M. Berenholtz, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated the effect of a multifaceted intervention to improve compliance with five evidence-based practices, known as the ventilator care bundle, which prevent VAP among mechanically ventilated patients. Data from 112 ICUs were collected, including the number of VAPs and ventilator-days at baseline, over the course of 30 months.

The researchers found that multifaceted intervention successfully increased use of evidence-based therapies and was associated with a significant and lasting decrease in VAP rates. There was a significant reduction in the overall median VAP rate from 5.5 cases (mean, 6.9 cases) per 1,000 ventilator-days at baseline to zero cases (mean, 3.4 cases) at 28 to 30 months after implementation of the program. Rates of compliance with evidence-based therapies increased significantly from 32 percent at baseline to 75 percent 16 to 18 months later, and to 84 percent by the end of the study period.

"We have demonstrated that VAP can be successfully prevented across a large and diverse cohort of ICUs. Our multifaceted VAP intervention was implemented without expensive technology or funding for the participating ICUs. Broad use of this multifaceted intervention could significantly reduce morbidity, mortality, and costs of care attributed to VAP," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, and one author created and has licensed technical support of the Safety Attitudes Questionnaire, which was used in the study.

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