Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit

被引:65
作者
Blamoun, John [1 ,2 ,4 ]
Alfakir, Maria [3 ,4 ]
Rella, Marie E. [5 ]
Wojcik, Janice M. [6 ]
Solis, Roberto A. [1 ,2 ,4 ]
Khan, M. Anees [1 ,2 ,4 ]
DeBari, Vincent A. [1 ,4 ]
机构
[1] Seton Hall Univ, Sch Hlth & Med Sci, Dept Internal Med, S Orange, NJ 07079 USA
[2] Seton Hall Univ, Div Pulm Med, S Orange, NJ 07079 USA
[3] Mt Sinai Sch Med, Dept Internal Med, New York, NY USA
[4] St Josephs Reg Med Ctr, Dept Med, Paterson, NJ USA
[5] St Josephs Reg Med Ctr, Dept Infect Control, Paterson, NJ USA
[6] St Josephs Reg Med Ctr, Dept Nursing, Paterson, NJ USA
关键词
PREVENTION;
D O I
10.1016/j.ajic.2008.05.010
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The ventilator bundle (VB) includes a group of clinical maneuvers (head-of-bed elevation, "sedation vacation:" deep vein thrombosis prophylaxis, and peptic ulcer disease prophylaxis) to improve outcomes in patients undergoing mechanical ventilation. We modified the standard VB in our medical intensive care unit to include a group of respiratory therapist-driven protocols and, post-implementation, observed a statistically significant (P = .0006) reduction in ventilator-associated pneumonia (VAP), from a median of 14.1 cases/10(3) ventilator-days (interquartile range [IQR] = 12.1 to 20.6) to 0 cases/10(3) ventilator-days (IQR = 0 to 1.1). Copyright (C) 2009 Association for Professionals in Infection Control and Epidemiology, Inc.
引用
收藏
页码:172 / 175
页数:4
相关论文
共 12 条
[1]  
Tablan Ofelia C, 2004, MMWR Recomm Rep, V53, P1
[3]  
[Anonymous], IMPL VENT BUNDL
[4]   Ventilator bundle approach to prevention of ventilator-associated pneumonia [J].
Burger, Charles D. ;
Resar, Roger K. .
MAYO CLINIC PROCEEDINGS, 2006, 81 (06) :849-850
[5]   Risk factors for ICU-acquired pneumonia [J].
Cook, DJ ;
Kollef, MH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (20) :1605-1606
[6]   Mechanical ventilator weaning protocols driven by nonphysician health-care professionals - Evidence-based clinical practice guidelines [J].
Ely, EW ;
Meade, MO ;
Haponik, EF ;
Kollef, MH ;
Cook, DJ ;
Guyatt, GH ;
Stoller, JK .
CHEST, 2001, 120 (06) :454S-463S
[7]   Toward a Zero VAP Rate Personal and Team Approaches in the ICU [J].
Fox, Maria Y. .
CRITICAL CARE NURSING QUARTERLY, 2006, 29 (02) :108-114
[8]   Prevention of ventilator-associated pneumonia: analysis of studies published since 2004 [J].
Gastmeier, P. ;
Geffers, C. .
JOURNAL OF HOSPITAL INFECTION, 2007, 67 (01) :1-8
[9]   Using a Bundle Approach to Improve Ventilator Care Processes and Reduce Ventilator-Associated Pneumonia [J].
Resar, Roger ;
Pronovost, Peter ;
Haraden, Carol ;
Simmonds, Terri ;
Rainey, Thomas ;
Nolan, Thomas .
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY, 2005, 31 (05) :243-248
[10]   Early goal-directed therapy in the treatment of severe sepsis and septic shock. [J].
Rivers, E ;
Nguyen, B ;
Havstad, S ;
Ressler, J ;
Muzzin, A ;
Knoblich, B ;
Peterson, E ;
Tomlanovich, M .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (19) :1368-1377