Critical Care Medicine

Adult Critical Care

Reducing ventilator-associated pneumonia in intensive care: Impact of implementing a care bundle

Morris AC, Hay AW, Swann DG, et al (Univ of Edinburgh, Scotland; Royal Infirmary Edinburgh, Scotland) Crit Care Med 39:2218-2224, 2011^§

Abstract

Objectives

Ventilator-associated pneumonia is the most common intensive care unit-acquired infection. Although there is widespread consensus that evidenced-based interventions reduce the risk of ventilator-associated pneumonia, controversy has surrounded the importance of implementing them as a “bundle” of care. This study aimed to determine the effects of implementing such a bundle while controlling for potential confounding variables seen in similar studies.

Design

A before-and-after study conducted within the context of an existing, independent, infection surveillance program.

Setting

An 18-bed, mixed medical–surgical teaching hospital intensive care unit.

Patients

All patients admitted to intensive care for 48 hrs or more during the periods before and after intervention.

Interventions

A four-element ventilator-associated pneumonia prevention bundle, consisting of head-of-bed elevation, oral chlorhexidine gel, sedation holds, and a weaning protocol implemented as part of the Scottish Patient Safety Program using Institute of Health Care Improvement methods.

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