The Combination Strategy to Reduce Early Ventilator Associated Pneumonia

摘要

Background: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units(ICUs), leading to increase in mortality and length of ICU and hospital stay as well as duration of mechanical ventilationand hospital charges . Methods: In a controlled clinical trial, 117 patients undergoing mechanical ventilation were evaluated in ICU in two groups comprising control (n=71) and intervention (n=46); the former received the ward's routine care, and the latter received planned nursing care protocols. Incidence of pneumonia was investigated using clinical pulmonary infectionscore system (CPIS) and Mini-BAL method . Results: The incidence of early VAP was 19.6% and 40.8% in the intervention and the control groups respectively (P0.001). The early VAP rate was 22.8 and 14.41 per 1000 ventilator days in control and the intervention groups.respectively. Length of ICU (P 0.02) and hospital (P0.001) stay and also duration of mechanical ventilation (P0.001)showed significant reduction in the intervention group compared to the controls. Conclusions: Precise implementation of planned and evidence-based nursing care is effective in reducing incidence,duration and hospital stay associated with early VAP .