Incidence of ventilator-associated pneumonia (VAP) after the institution of an educational program on VAP prevention

Narong Kulvatunyou, Aree Boonbarwornrattanakul, Yupa Soonthornkit, Chortip Kocharsanee, Panuwat Lertsithichai
Journal of the Medical Association of Thailand 2007, 90 (1): 89-95

OBJECTIVE: Demonstrate if the institution of an educational program on VAP and its prevention is effective in helping reduce the incidence of VAP in a surgical ICU.

MATERIAL AND METHOD: An educational program on VAP and its prevention, which consisted of a 1-hour formal lecture, an educational handout, and a pre-and post-test exam was given to the nursing staff beginning in April 1st, 2003. Reminding posters were posted throughout the ICU. The pre-and post-intervention clinical data that included age, sex, diagnosis, APACHE II, ventilator days, and incidence of VAP were collected. VAP was considered to have occurred only after the patient had been on mechanical ventilation for greater than 48 hours. The primary outcome measure was the incidence of VAP The secondary outcome measures were duration of the ICU and hospital stay, and the ICU and hospital mortality. Values were expressed as mean +/- standard deviation, and median (range). Multiple logistic regression analysis of various variables was used to identify risk factors for the occurrence of the VAP.

RESULTS: Eight-five patients in Pre- (July 1st, 2002 to June 30th, 2003) and 89 patients in post- (July 1st, 2003 to June 30th, 2004) intervention met the inclusion criteria. The incidence of VAP decreased from 39.7 per 1000 ventilator-day to 10.5 per 1000 ventilator-day (p-value < 0.001) after the institution of an educational program. The ICU, hospital length of stay, and the mortality rate remained unchanged. Age and the interventional program were found to correlate with the occurrence of VAP.

CONCLUSION: An institution of an educational program on VAP and its prevention helps reduce the incidence of the VAP at the study institution but does not affect the ICU, hospital length of stay, and the mortality rate.

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