Impact of a Monitored Program of Care on Incidence of Ventilator-Associated Pneumonia: Results of a Longterm Performance-Improvement Project

Temporal Trends of Ventilator-Associated Pneumonia Incidence and the Effect of Implementing Health-care Bundles in a Suburban Community

“…Bronchoscopy 5 (10) 6 (12) 3 (7) 8 (12) 10 (20) 8 (19) 11 (26) . 16 22 (10) 29 (21) .005 ETA 27 (53) 34 (65) 31 (72) 38 (57) 28 (55) 31 (72) 22 (51) .84…”

“…17 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) 19 16 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) 16 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) 16 (9)(10)(11)(12)(13)(14)…”

“…This may also explain a lower prebundle incidence than previously published reports. [21][22][23]26 Although a checklist approach may lead to a higher compliance with health-care bundles, [29][30][31] their effect on the prevention of VAP occurrence is affected by different implementation strategies. 23,25 Another important point is that with only approximately 45 patients per year, the rates in any 1-year period are intrinsically unstable and may adversely infl uence the analysis.…”

“…[34][35][36] Although their VAP rates through applying subjective criteria more and more strictly, leading to lower and lower VAP rates. Some ICUs in the United States claimed a nearzero VAP rate, [21][22][23][24][25][26] which was more likely attributed to the strong fi nancial pressures on hospitals to minimize their VAP rates rather than an actual improvement in health-care management. Although variability in VAP diagnosis can be infl uenced by the technique used to obtain microbiologic specimens, similar to other settings, our surveillance data showed that bronchoscopy examination and quantitative culture of endotracheal aspiration was not routinely performed in clinical practice.…”

Reducing paediatric ventilator-associated pneumonia – a South African challenge!

“…For full compliance, adherence to all five bundle elements had to be maintained and a target of 90% compliance was set, similar to previous studies. [10] VAP cases were reported, using standardised tools, at the same time each day. Initially, cases were recorded daily on one page without individual CPIS scores.…”