Effectiveness of an Educational Program to Reduce Ventilator-Associated Pneumonia in a Tertiary Care Center in Thailand: A 4-Year Study
| Autor: | Victoria J. Fraser, Boonyasit Warachan, Jeanne E. Zack, Chanart Yuekyen, David K. Warren, Anucha Apisarnthanarak, Kanokporn Thongphubeth, Uayporn Pinitchai |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Microbiology (medical)
Pediatrics medicine.medical_specialty Time Factors Cost effectiveness medicine.medical_treatment Respiratory therapist law.invention law Intensive care Humans Medicine Prospective Studies Prospective cohort study Health Education Cross Infection business.industry Incidence (epidemiology) Ventilator-associated pneumonia Pneumonia Ventilator-Associated Thailand medicine.disease Intensive care unit Hospitalization Intensive Care Units Infectious Diseases Emergency medicine Coronary care unit business Program Evaluation |
| Zdroj: | Clinical Infectious Diseases. 45:704-711 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1086/520987 |
| Popis: | Ventilator-associated pneumonia (VAP) is considered to be an important cause of infection-related death and morbidity in intensive care units (ICUs). We sought to determine the long-term effect of an educational program to prevent VAP in a medical ICU (MICU). A 4-year controlled prospective quasi-experimental study was conducted in an MICU surgical ICU (SICU) and coronary care unit (CCU) for 1 year before the intervention (period 1) 1 year after the intervention (period 2) and 2 follow-up years (period 3). The SICU and CCU served as control ICUs. The educational program involved respiratory therapists and nurses and included a self-study module with preintervention and postintervention assessments lectures fact sheets and posters. Before the intervention there were 45 episodes of VAP (20.6 cases per 1000 ventilator-days) in the MICU 11 (5.4 cases per 1000 ventilator-days) in the SICU and 9 (4.4 cases per 1000 ventilator-days) in the CCU. After the intervention the rate of VAP in the MICU decreased by 59% (to 8.5 cases per 1000 ventilator-days; p = .001) and remained stable in the SICU (5.6 cases per 1000 ventilator-days; P = .22) and CCU (4.8 cases per 1000 ventilator-days; P = .48). The rate of VAP in the MICU continued to decrease in period 3 (to 4.2 cases per 1000 ventilator-days; P = .07) and rates in the SICU and CCU remained unchanged. Compared with period 1 the mean duration of hospital stay in the MICU was reduced by 8.5 days in period 2 (P < .001) and by 8.9 days in period 3 (P < .001). The monthly hospital antibiotic costs of VAP treatment and the hospitalization cost for each patient in the MICU in periods 2 and 3 were also reduced by 45%-50% (P < .001) and 37%-45% (P < .001) respectively. A focused education intervention resulted in sustained reductions in the incidence of VAP duration of hospital stay cost of antibiotic therapy and cost of hospitalization. (authors) |
| Databáze: | OpenAIRE |
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