Effect of Bundle Interventions on Ventilator-associated Pneumonia in Intensive Care Unit_West China Medical Journal

Authors：

 LIUZhu ¹ ,  HUANGQiong-hua ² , ANHan ¹ , DENGXiao-hua ¹

1. Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nosocomial Infection Management, the First People's Hospital of Shuangliu County, Chengdu, Sichuan 610200, P. R. China;

Corresponding?author：

HUANGQiong-hua, Email: 791848916@qq.com

Keywords：

Ventilator-associated pneumonia; Intensive care unit; Bundle interventions

DOI：

10.7507/1002-0179.20140134

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe the effect of bundle interventions on ventilator-associated pneumonia (VAP) in Intensive Care Unit (ICU). Methods Baseline survey among the patients undergoing mechanical ventilation was conducted during June 2011 to August 2011. During September 2011 to May 2012, the rate of VAP was monitored every three months after taking bundle measures, which included oral care, elevation of the head of the bed, daily assessment of readiness to extubation, optimizing process of devices disinfection and hand hygiene. Results Through carrying out the bundle interventions, the VAP rate decreased from 61.2‰ to 34.9‰ after six months and 22.7‰ after nine months, and the ventilator utilization ratio decreased from 26.5% to 24.6% after six months and 22.6% after nine months. The alcohol-based hand disinfectant dosage was increased from 32.6 mL to 58.8 mL and 54.4 mL for each patient bed in ICU. Conclusion The bundle intervention has been proved to be effective. Measures such as staff education, bedside supervision and monitoring data feedback can help implement bundle interventions.

Citation： LIUZhu, HUANGQiong-hua, ANHan, DENGXiao-hua. Effect of Bundle Interventions on Ventilator-associated Pneumonia in Intensive Care Unit. West China Medical Journal, 2014, 29(3): 449-451. doi: 10.7507/1002-0179.20140134 Copy

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11.	單君, 吳娟, 顧艷葒, 等. 集束干預策略對預防呼吸機相關肺炎的臨床研究[J]. 護士進修雜志, 2012, 27(3):202-205.
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13.	譚景予, 陳錦秀. 呼吸機相關性肺炎集束化護理方案的制訂與管理[J]. 中華護理雜志, 2011, 46(7):731-733.
14.	Berenholtz SM, Pham JC, Thompson DA, et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit[J]. Infect Control Hosp Epidemiol, 2011, 32(4):305-314.
15.	Greene LR, Farnsworth D, Dumyati G. 10 Years after NNIS; the use of comparative data as a catalyst for organizational improvement[J]. Am J Infect Control, 2006, 34(5):E77-E78.

1. Leblebicioglu H, Rosenthal VD, Arikan OA, et al. Device-associated hospital-acquired infection rates in Turkish intensive care units. Findings of the International Nosocomial Infection Control Consortium (INICC)[J]. J Hosp Infect, 2007, 65(3):251-257.
2. 中華人民共和國衛生部. WS/T 312-2009醫院感染監測規范[S]. 2009.
3. 中華人民共和國衛生部. 醫院感染診斷標準[J]. 中華醫學雜志, 2001, 81(5):314-320.
4. Arabi Y, Al-Shirawi N, Memish Z, et al. Ventilator-associated pneumonia in adults in developing countries:a systematic review[J]. Int J Infect Dis, 2008, 12(5):505-512.
5. Amin A. Clinical and economic Consequences of ventilator-associated pneumonia[J]. Clin Infect Dis, 2009, 49(Suppl 1):S36-S43.
6. Ducel G, Fabry J, Nicolle LE. Prevention of hospital-acquired infections:a practical guide[M]. 2nd ed. Geneva:World Health Organization, 2002:1-64.
7. Tablan OC, Anderson LJ, Besser R, et al. Guidelines for preventing healthcare-associated pneumonia, 2003:recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee[J]. MMWR Recomm Rep, 2004, 53(RR/3):1-36.
8. Torres A, Ewig S, Lode H, et al. Defining, treating and preventing hospital acquired pneumonia:European perspective[J]. Intensive Care Med, 2009, 35(1):9-29.
9. Koff MD, Corwin HL, Beach ML. et al. Reduction in ventilator associated pneumonia in a mixed intensive care uint after initiation of a novel hand hygiene program[J]. J Crit Care, 2011, 26(5):489-495.
10. Wip C, Napolitano L. Bundles to prevent ventilator-associated pneumonia:how valuable are they?[J]. Curr Opin Infect Dis, 2009, 22(2):159-166.
11. 單君, 吳娟, 顧艷葒, 等. 集束干預策略對預防呼吸機相關肺炎的臨床研究[J]. 護士進修雜志, 2012, 27(3):202-205.
12. 駱玉喬. 非藥物性干預措施對ICU呼吸機相關性肺炎發生的影響[J]. 中華醫院感染學雜志, 2012, 22(12):2519-2520.
13. 譚景予, 陳錦秀. 呼吸機相關性肺炎集束化護理方案的制訂與管理[J]. 中華護理雜志, 2011, 46(7):731-733.
14. Berenholtz SM, Pham JC, Thompson DA, et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit[J]. Infect Control Hosp Epidemiol, 2011, 32(4):305-314.
15. Greene LR, Farnsworth D, Dumyati G. 10 Years after NNIS; the use of comparative data as a catalyst for organizational improvement[J]. Am J Infect Control, 2006, 34(5):E77-E78.

West China Medical Journal

Effect of Bundle Interventions on Ventilator-associated Pneumonia in Intensive Care Unit

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