Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: Findings of the International Nosocomial Infection Control Consortium

• Published in: Journal of critical care 2012-10, Vol.27 (5), p.440-446
• Main Authors: Tao, Lili, MD, Hu, Bijie, MD, Rosenthal, Victor Daniel, MD, Zhang, Yiwen, MD, Gao, Xiaodong, MD, He, Lixian, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; China; Compliance; Critical Care; Cross Infection - epidemiology; Cross Infection - prevention & control; Developing countries; Device-associated infection; Education; Feedback; Female; Guideline Adherence; Hospital costs; Hospitals, University - organization & administration; Humans; Hygiene; Infection Control - organization & administration; Inservice Training - organization & administration; Intensive care; Intensive Care Units - organization & administration; International Nosocomial Infection Control Consortium; Intervention; Intubation; LDCs; Male; Middle Aged; Mortality; Multidimensional approach; Nosocomial infections; Nurses; Pneumonia, Ventilator-Associated - epidemiology; Pneumonia, Ventilator-Associated - prevention & control; Practice Guidelines as Topic; Program Evaluation; Ventilation; Ventilator-associated pneumonia; Ventilators
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2011.12.018

Abstract Purpose The aim of this study was to analyze the impact of a multidimensional infection control approach on the reduction of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) patients of one hospital in China. Materials and Methods We conducted a before-after study from January 2005 to July 2009, which was divided into baseline (phase 1) and intervention (phase 2) periods. During phase 1, active prospective outcome surveillance of VAP was performed by applying the definitions of the Centers for Disease Control and Prevention/National Health Safety Network, and the methodology of the International Nosocomial Infection Control Consortium. During phase 2, the multidimensional approach was implemented. Ventilator-associated pneumonia rates obtained in phases 1 and 2 were compared in yearly periods. Results We recorded data from 16 429 patients hospitalized in 3 ICUs, for a total of 74 116 ICU bed days. The VAP baseline rate was 24.1 per 1000 ventilator-days. During phase 2, the VAP rate significantly decreased to 5.7 per 1000 ventilator-days in 2009 (2009 vs 2005: relative risk, 0.31; 95% confidence interval, 0.16-0.36; P = .0001), amounting to a 79% cumulative VAP rate reduction. Conclusions Implementing a multidimensional infection control intervention for VAP was associated with a significant cumulative reduction in the VAP rate in our ICUs.