2 research outputs found
Prevention of ventilator-associated pneumonia: the multimodal approach of the spanish ICU pneumonia zero program.
Objectives:
The âPneumonia Zeroâ project is a nationwide multimodal intervention based on the simultaneous implementation of a comprehensive evidence-based bundle measures to prevent ventilator-associated pneumonia in critically ill patients admitted to the ICU.
Design:
Prospective, interventional, and multicenter study.
Setting:
A total of 181 ICUs throughout Spain.
Patients:
All patients admitted for more than 24 hours to the participating ICUs between April 1, 2011, and December 31, 2012.
Intervention:
Ten ventilator-associated pneumonia prevention measures were implemented (seven were mandatory and three highly recommended). The database of the National ICU-Acquired Infections Surveillance Study (Estudio Nacional de Vigilancia de Infecciones Nosocomiales [ENVIN]) was used for data collection. Ventilator-associated pneumonia rate was expressed as incidence density per 1,000 ventilator days. Ventilator-associated pneumonia rates from the incorporation of the ICUs to the project, every 3 months, were compared with data of the ENVIN registry (AprilâJune 2010) as the baseline period. Ventilator-associated pneumonia rates were adjusted by characteristics of the hospital, including size, type (public or private), and teaching (postgraduate) or university-affiliated (undergraduate) status.
Measurements and Main Results:
The 181 participating ICUs accounted for 75% of all ICUs in Spain. In a total of 171,237 ICU admissions, an artificial airway was present on 505,802 days (50.0% of days of stay in the ICU). A total of 3,474 ventilator-associated pneumonia episodes were diagnosed in 3,186 patients. The adjusted ventilator-associated pneumonia incidence density rate decreased from 9.83 (95% CI, 8.42â11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22â5.84) after 19â21 months of participation.
Conclusions:
Implementation of the bundle measures included in the âPneumonia Zeroâ project resulted in a significant reduction of more than 50% of the incidence of ventilator-associated pneumonia in Spanish ICUs. This reduction was sustained 21 months after implementation
Prevention of ventilator-associated pneumonia: the multimodal approach of the spanish ICU pneumonia zero program.
Objectives:
The âPneumonia Zeroâ project is a nationwide multimodal intervention based on the simultaneous implementation of a comprehensive evidence-based bundle measures to prevent ventilator-associated pneumonia in critically ill patients admitted to the ICU.
Design:
Prospective, interventional, and multicenter study.
Setting:
A total of 181 ICUs throughout Spain.
Patients:
All patients admitted for more than 24 hours to the participating ICUs between April 1, 2011, and December 31, 2012.
Intervention:
Ten ventilator-associated pneumonia prevention measures were implemented (seven were mandatory and three highly recommended). The database of the National ICU-Acquired Infections Surveillance Study (Estudio Nacional de Vigilancia de Infecciones Nosocomiales [ENVIN]) was used for data collection. Ventilator-associated pneumonia rate was expressed as incidence density per 1,000 ventilator days. Ventilator-associated pneumonia rates from the incorporation of the ICUs to the project, every 3 months, were compared with data of the ENVIN registry (AprilâJune 2010) as the baseline period. Ventilator-associated pneumonia rates were adjusted by characteristics of the hospital, including size, type (public or private), and teaching (postgraduate) or university-affiliated (undergraduate) status.
Measurements and Main Results:
The 181 participating ICUs accounted for 75% of all ICUs in Spain. In a total of 171,237 ICU admissions, an artificial airway was present on 505,802 days (50.0% of days of stay in the ICU). A total of 3,474 ventilator-associated pneumonia episodes were diagnosed in 3,186 patients. The adjusted ventilator-associated pneumonia incidence density rate decreased from 9.83 (95% CI, 8.42â11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22â5.84) after 19â21 months of participation.
Conclusions:
Implementation of the bundle measures included in the âPneumonia Zeroâ project resulted in a significant reduction of more than 50% of the incidence of ventilator-associated pneumonia in Spanish ICUs. This reduction was sustained 21 months after implementation