Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings

Background Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including...

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Published inAmerican journal of infection control Vol. 40; no. 6; pp. 497 - 501
Main Authors Rosenthal, Victor D., MD, MSc, CIC, Álvarez-Moreno, Carlos, MD, Villamil-Gómez, Wilmer, MD, Singh, Sanjeev, MD, Ramachandran, Bala, MD, Navoa-Ng, Josephine A., MD, Dueñas, Lourdes, MD, Yalcin, Ata N., MD, Ersoz, Gulden, MD, Menco, Antonio, MD, Arrieta, Patrick, MD, Bran-de Casares, Ana C., RN, de Jesus Machuca, Lilian, RN, Radhakrishnan, Kavitha, MD, Villanueva, Victoria D., RN, Tolentino, Maria C.V., RN, Turhan, Ozge, MD, Keskin, Sevim, RN, Gumus, Eylul, RN, Dursun, Oguz, MD, Kaya, Ali, MD, Kuyucu, Necdet, MD
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.08.2012
Elsevier
Mosby-Year Book, Inc
Subjects
Biological and medical sciences
Bundle
Child, Preschool
Critical care
Developing Countries
Device-associated infection
Disease control
Emerging countries
Epidemiology. Vaccinations
Feedback
Female
General aspects
Hand hygiene
Handwashing
Health care–acquired infection
Hospital infection
Hospital-acquired pneumonia
Human infectious diseases. Experimental studies and models
Humans
Incidence density
Infant
Infection Control
Infection Control - methods
Infectious Disease
Infectious diseases
Intensive care
Intensive Care Units, Pediatric
Limited-resource countries
Low-income countries
Male
Medical sciences
Multifaceted strategy
Nosocomial infections
Nosocomial pneumonia
Pediatrics
Pneumology
Pneumonia
Pneumonia, Ventilator-Associated - prevention & control
Prevalence
Rate
Respiratory system : syndromes and miscellaneous diseases
Surveillance
Hospital-acquired pneumonia
Handwashing
Low-income countries
Emerging countries
Rate
Bundle
Critical care
Multifaceted strategy
Health care–acquired infection
Infection control
Surveillance
Hand hygiene
Nosocomial pneumonia
Hospital infection
Device-associated infection
Limited-resource countries
Incidence density
Nosocomial infection
Pediatrics
Pneumonia
Check
Developing countries
Washing
Artificial ventilation
Epidemiology
Intensive care unit
Incidence
Prevention
Child
Human
Lung disease
Respiratory disease
Device
Disinfection
Hand
Health care-acquired infection
Hygiene
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Abstract Background Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. Methods This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care—associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. Results During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P  = .02), demonstrating a 31% reduction in VAP rate. Conclusions Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
AbstractList Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate. Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
BACKGROUNDVentilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries.METHODSThis was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology.RESULTSDuring the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate.CONCLUSIONSOur results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
Background Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. Methods This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care—associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. Results During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P  = .02), demonstrating a 31% reduction in VAP rate. Conclusions Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate. Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate. Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries. 50 references
Author Menco, Antonio, MD
Villamil-Gómez, Wilmer, MD
Villanueva, Victoria D., RN
Dueñas, Lourdes, MD
Radhakrishnan, Kavitha, MD
Yalcin, Ata N., MD
Keskin, Sevim, RN
Rosenthal, Victor D., MD, MSc, CIC
Ersoz, Gulden, MD
Bran-de Casares, Ana C., RN
Navoa-Ng, Josephine A., MD
de Jesus Machuca, Lilian, RN
Singh, Sanjeev, MD
Gumus, Eylul, RN
Turhan, Ozge, MD
Tolentino, Maria C.V., RN
Kuyucu, Necdet, MD
Arrieta, Patrick, MD
Álvarez-Moreno, Carlos, MD
Kaya, Ali, MD
Ramachandran, Bala, MD
Dursun, Oguz, MD
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2012 Association for Professionals in Infection Control and Epidemiology, Inc.
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Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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Issue 6
Keywords Hospital-acquired pneumonia
Handwashing
Low-income countries
Emerging countries
Rate
Bundle
Critical care
Multifaceted strategy
Health care–acquired infection
Infection control
Surveillance
Hand hygiene
Nosocomial pneumonia
Hospital infection
Device-associated infection
Limited-resource countries
Incidence density
Nosocomial infection
Pediatrics
Pneumonia
Check
Developing countries
Washing
Artificial ventilation
Epidemiology
Intensive care unit
Incidence
Prevention
Child
Human
Lung disease
Respiratory disease
Device
Disinfection
Hand
Health care-acquired infection
Hygiene
Language English
License CC BY 4.0
Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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Snippet Background Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs)....
Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs). Practice bundles...
Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles...
BACKGROUNDVentilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice...
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SubjectTerms Biological and medical sciences
Bundle
Child, Preschool
Critical care
Developing Countries
Device-associated infection
Disease control
Emerging countries
Epidemiology. Vaccinations
Feedback
Female
General aspects
Hand hygiene
Handwashing
Health care–acquired infection
Hospital infection
Hospital-acquired pneumonia
Human infectious diseases. Experimental studies and models
Humans
Incidence density
Infant
Infection Control
Infection Control - methods
Infectious Disease
Infectious diseases
Intensive care
Intensive Care Units, Pediatric
Limited-resource countries
Low-income countries
Male
Medical sciences
Multifaceted strategy
Nosocomial infections
Nosocomial pneumonia
Pediatrics
Pneumology
Pneumonia
Pneumonia, Ventilator-Associated - prevention & control
Prevalence
Rate
Respiratory system : syndromes and miscellaneous diseases
Surveillance
Title Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings
URI https://www.clinicalkey.es/playcontent/1-s2.0-S0196655311010169
https://dx.doi.org/10.1016/j.ajic.2011.08.005
https://www.ncbi.nlm.nih.gov/pubmed/22054689
https://www.proquest.com/docview/1030943253/abstract/
https://search.proquest.com/docview/1031155636
https://search.proquest.com/docview/1223810550
Volume 40
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