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"Ventilator associated pneumonia"

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"Ventilator associated pneumonia"

Original Articles
The Development and Effectiveness of a Program to Prevent Ventilator Associated Pneumonia in the ICU
Keum Ok Ban
J Korean Acad Adult Nurs 2009;21(2):155-166.   Published online April 30, 2009
PURPOSE
This study developed and evaluated a systematic intervention among medical ICU nurses for preventing ventilator-associated pneumonia (hereafter VAP).
METHODS
A VAP prevention program was proposed based on a literature review, revised to fit the target situation, and validated. It was composed of one-time interventions including education, pamphlets, hand cultures, and a quiz event, as well as repeated interventions such as posters, reminders, posting hand culture results, and performance feedback. A simulated control group pretest-posttest design was used to verify the effectiveness of the VAP control program. The incidence of VAP among ICU patients was measured both during 3 months before (n = 80) and during 3 months after (n = 75) intervention.
RESULTS
The VAP prevention program's effectiveness, with a pre-intervention VAP rate of 17.38 and post-intervention rate of 11.04 per 1,000 ventilator days, showed a clinical tendency to decrease, but the difference was not statistically significant (p = .750).
CONCLUSION
A VAP prevention program of multiple interventions can be useful in decreasing the VAP rate. Given that the monthly decrease in the VAP rate was not considered statistically significant, long-term research needs to be done. Additionally, since this study targeted only nurses, it is suggested that future research targets other health care workers who can influence VAP rates.
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The Incidence Rate of Ventilator Associated Pneumonia in Relation to the Exchange of Circuit Cycle
Nam Cho Kim, Yang Ree Kim
J Korean Acad Adult Nurs 2003;15(3):463-471.   Published online September 30, 2003
PURPOSE
This study was aimed at providing scientific evidence for minimizing ventilator-associated pneumonia(VAP) by identifying appropriate timing of exchange of circuit for mechanical ventilator that is well suitable for the medical environment of intensive care units of hospitals in Korea.
METHOD
This was a quasi-experimental study with a convenience sample of 19 adult subjects aged over 18 years who were admitted to the NS ICU of C university hospital, and placed on mechanical ventilator. The subjects were placed in two groups, compared on the incidence rate of VAP after they received exchange of circuit either at 1-week interval (N =10) or 2-week interval (N = 9).
RESULT
1) When considering 1000 days as the standard unit of analysis for incidence, the incidence rate of VAP was 7.19 cases at the 1-week cycle exchange group and 15.23 at the 2-week cycle exchange group, showing no statistically significant difference between the two groups. 2) There were a total of 3 types of bacteria isolated from the patients with VAP, including 2 cases with P. aeruginosa, 1 case with Streptococcus group F and A. baumannii.
CONCLUSION
With thorough hand washing and strict management of tracheal tube of mechanical ventilator as well as use of tracheal intubation techniques, exchange cycle of circuit of mechanical ventilator by nurses may be changed from 1-week to 2-week interval.
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