Bert Maertens, Stijn Blot, Diana Huis In 't Veld, Koen Blot, Annelies Koch, Katrien Mignolet, Elise Pannier, Tom Sarens, Werner Temmerman, Walter Swinnen
{"title":"逐步实施预防策略及其对呼吸机相关肺炎发病率的影响:一项为期 13 年的观察性监测研究。","authors":"Bert Maertens, Stijn Blot, Diana Huis In 't Veld, Koen Blot, Annelies Koch, Katrien Mignolet, Elise Pannier, Tom Sarens, Werner Temmerman, Walter Swinnen","doi":"10.1016/j.iccn.2024.103769","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</p><p><strong>Design: </strong>Historical observational surveillance study conducted over 13 years.</p><p><strong>Setting: </strong>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</p><p><strong>Participants: </strong>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</p><p><strong>Interventions: </strong>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.</p><p><strong>Measurements and main results: </strong>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</p><p><strong>Conclusions: </strong>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</p><p><strong>Implications for practice: </strong>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study.\",\"authors\":\"Bert Maertens, Stijn Blot, Diana Huis In 't Veld, Koen Blot, Annelies Koch, Katrien Mignolet, Elise Pannier, Tom Sarens, Werner Temmerman, Walter Swinnen\",\"doi\":\"10.1016/j.iccn.2024.103769\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</p><p><strong>Design: </strong>Historical observational surveillance study conducted over 13 years.</p><p><strong>Setting: </strong>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</p><p><strong>Participants: </strong>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</p><p><strong>Interventions: </strong>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.</p><p><strong>Measurements and main results: </strong>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</p><p><strong>Conclusions: </strong>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</p><p><strong>Implications for practice: </strong>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</p>\",\"PeriodicalId\":94043,\"journal\":{\"name\":\"Intensive & critical care nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Intensive & critical care nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.iccn.2024.103769\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive & critical care nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.iccn.2024.103769","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study.
Objective: To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.
Design: Historical observational surveillance study conducted over 13 years.
Setting: A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.
Participants: Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.
Interventions: Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.
Measurements and main results: A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.
Conclusions: Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.
Implications for practice: The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.