Preventing ventilator-associated pneumonia in adults - Sowing seeds of change

被引:103
作者
Craven, Donald E. [1 ]
机构
[1] Lahey Clin Med Ctr, Dept Infectious Dis, Burlington, MA 01805 USA
关键词
antibiotics; evidence-based data; guidelines; infection control; Institute for Healthcare Improvement; intensive care; prevention of hospital-acquired pneumonia; ventilator-associated pneumonia;
D O I
10.1378/chest.130.1.251
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Ventilator-associated pneumonia (VAP), a major cause of ICU infection, results in high morbidity, mortality, and health-care costs. Multiple risk factors for VAP involve complex host factors and ubiquitous pathogens that require several different types of prevention strategies. Prevention efforts, should focus on reducing bacterial colonization, and limiting aspiration, antibiotic exposure, and use of invasive devices. Although evidence-based prevention guidelines are available, they are lengthy, often ignored, and not implemented. New insights into the barriers to implementation of effective prevention programs are emerging. This article provides highlights from recent guidelines and publications discussing VAP prevention strategies and examines barriers to their implementation. Prevention and implementation of cost-effective strategies to reduce risk and improve patient outcomes should be prioritized. Clearly, prevention programs should be population specific and may vary among hospitals', but a multidisciplinary prevention team led by a "champion" is recommended to help set priorities, benchmarking goals, analyze data, and sow the seeds of change for risk reduction.
引用
收藏
页码:251 / 260
页数:10
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