RT Journal Article
SR Electronic
T1 The impact of VAP staff education on VAP morbidity and mortality in Alexandria University
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA702
DO 10.1183/13993003.congress-2015.PA702
VO 46
IS suppl 59
A1 Ahmed Elmenshawy
A1 Tarek Elbadawy
A1 Hassan Abu khaber
A1 Soad Hafez
A1 Akram Fayed
A1 Emad Ibrahim
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA702.abstract
AB Aim: to determine the efficiency (VAP rate) and efficacy (mechanical ventilation morbidity and mortality) of VAP staff education with deficient supplies and lack of top management supportMethods: Quasi-experimental study with before and after prospective cohort in two medical/surgical ICUs of Alexandria university hospitals during the period from 2007 till 2013.Results: A total of 598 patients were enrolled in the study. The adherence to expanded VAP bundle significantly increased in the post-intervention phase as follows; head of bed elevation (from mean of 40 to 100% with p=0.001), oral care (from mean of 20 to 100% with p=0.001), daily sedation vacation (from mean of 56.5 to 91% with p=0.001), daily assessment of weaning (from mean of 9 to 25% with p=0. 03), peptic ulcer prophylaxis (from mean of 83 to 100% with p=0.001), DVT prophylaxis (from mean of 82 to 100% and p=0.001), cuff pressure measurement (from mean of 9 to 60% with p=0.001), and hand hygiene (from mean of 8 to 28.5% with p=0.001). The VAP rate decreased significantly by 35% (from 66.5 to 43 per 1000 MV days) with p= 0.002and CI 9.73 – 37.15 in spite of significant increase of the ventilator utilization ratio (p <0.001) in the post-intervention phase. Conclusions: In spite of the lack of top management support and fluctuating supplies, VAP staff education was still efficient in reducing VAP without affecting mortality or MV days or ICU length of stay.