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Impact of Care Bundle on Prevention of Ventilator Associated Pneumonia in an Adult Intensive Care Unit at a Rural Tertiary Teaching Hospital

Suresh Kumar Nagaiah , Anitha Deva1 , Suresh Kumar Nagaiah2 , Beena PM3 , Dinesh K4

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Indian Journal of Anesthesia and Analgesia 6(2):p 387-392, MARCH-APRIL 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.3

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Anitha Deva, Suresh Kumar Nagaiah, Beena P M et al. Impact of Care Bundle on Prevention of Ventilator Associated Pneumonia in an Adult Intensive Care Unit at a Rural Tertiary Teaching Hospital. Indian J Anesth Analg. 2019;6(2):387-392.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Objectives: To evaluate the incidence of ventilator associated pneumonia (VAP) before and after implementation of VAP Care bundle and to correlate incidence of VAP with Care bundle compliance. Methods: This is a prospective study conducted in an adult intensive care unit (ICU) from August 2016 to July 2018. Active surveillance of VAP cases was carried out and incidence was calculated as per CDC definition. The VAP Care bundle with following elements was introduced after training; head end elevation by 300, Chlorhexidine mouth care 6th hourly, daily sedation vacation and assessing readiness to wean from ventilator, peptic ulcer and DVT prophylaxis. To study the effect of Care bundle on incidence of VAP, 2 year retrospective data before Care bundle implementation was collected and analyzed. Care bundle compliance was assessed using a checklist for each intubated patient. Results: The incidence of VAP was 9.87 and 2.92 per 1000 ventilator days before and after implementation of Care bundle respectively. The reduction in average incidence of VAP rate before and after implementation of Care bundle is 6.95 per 1000 ventilator days with p<0.005 which is highly significant. The overall VAP bundle compliance rate was 80.33% with significant statistical correlation between the VAP rate and its bundle compliance (p<0.005). Conclusion: Significant reduction in the incidence of VAP rate can be achieved with strict adherence to VAP Care bundle, periodic training of health care workers with regard to infection control practices and active surveillance by the infection control team.

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Anitha Deva, Suresh Kumar Nagaiah, Beena P M et al. Impact of Care Bundle on Prevention of Ventilator Associated Pneumonia in an Adult Intensive Care Unit at a Rural Tertiary Teaching Hospital. Indian J Anesth Analg. 2019;6(2):387-392.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.3

Keywords

VAP Care bundle; VAP incidence rate; bundle compliance.

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