Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study
Abstract
OBJECTIVE
To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.
DESIGN
Historical observational surveillance study conducted over 13 years.
SETTING
A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.
PARTICIPANTS
Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.
INTERVENTIONS
Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.
MEASUREMENTS AND MAIN RESULTS
A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.
CONCLUSIONS
Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.
IMPLICATIONS FOR PRACTICE
The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.
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