www.ccnonline.org CriticalCareNurse Vol 36, No. 5, OCTOBER 2016 e1
Feature
Use of Ventilator Bundle
and Staff Education to
Decrease Ventilator-
Associated Pneumonia in
Intensive Care Patients
Maria Parisi, RN, MSc, PhD
Vasiliki Gerovasili, MD, PhD
Stavros Dimopoulos, MD, PhD
Efstathia Kampisiouli, RN, MSc
Christina Goga, MD
Efstathia Perivolioti, MD, PhD
Athina Argyropoulou, MD, PhD
Christina Routsi, MD, PhD
Sotirios Tsiodras, MD, PhD
Serafeim Nanas, MD, PhD
BACKGROUND Ventilator-associated pneumonia (VAP), one of the most common hospital-acquired infec-
tions, has a high mortality rate.
OBJECTIVES To evaluate the incidence of VAP in a multidisciplinary intensive care unit and to examine
the effects of the implementation of ventilator bundles and staff education on its incidence.
METHODS A 24-month-long before/after study was conducted, divided into baseline, intervention, and
postintervention periods. VAP incidence and rate, the microbiological profle, duration of mechanical
ventilation, and length of stay in the intensive care unit were recorded and compared between the periods.
RESULTS Of 1097 patients evaluated, 362 met the inclusion criteria. The baseline VAP rate was 21.6 per
1000 ventilator days. During the postintervention period, it decreased to 11.6 per 1000 ventilator days
(P = .01). Length of stay in the intensive care unit decreased from 36 to 27 days (P = .04), and duration of
mechanical ventilation decreased from 26 to 21 days (P = .06).
CONCLUSIONS VAP incidence was high in a general intensive care unit in a Greek hospital. However,
implementation of a ventilator bundle and staff education has decreased both VAP incidence and length
of stay in the unit. (Critical Care Nurse. 2016;36[5]:e1-e7)
©2016 American Association of Critical-Care Nurses doi: http://dx.doi.org/10.4037/ccn2016520
V
entilator-associated pneumonia (VAP) is one of the most common hospital-acquired infections.
It is a form of nosocomial pneumonia that occurs in patients undergoing mechanical ventilation
for longer than 48 hours.
1
Recently reported VAP rates range from 1 to 4 cases per 1000 ventilator
days in industrialized countries and up to 13 cases per 1000 ventilator days in developing countries.
2
VAP is the most serious health care–associated infection and is the leading cause of morbidity and
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