A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices

SummaryObjectivesWe aimed to examine organizational, structural and routine infection control measures provided by European ICUs and staff practices in ventilator-associated pneumonia prevention in relation with current recommendations.MethodsEuropean ICU staffs were invited to complete a web-based 20 closed-item questionnaire.Results675 nurses and 886 physicians from 13 countries answered the questionnaire. Median number of respondents per country was 118.0 (64.5–155.5). Availability and organizational aspects of infection control revealed wide variations between countries. Among them, single-patient rooms was the aspect with the lowest availability (median availability 38%), but the largest variation ranging from 15 to 84%. Self-reported median adherence rate to recommendations was 72% (34.5–83.0) with a strong correlation between nurses and physicians responses (r² = 0.96; p < 0.0001). Sub-glottic drainage (31%), and infrequent ventilatory-circuit change (24%) were the measures with the lowest adherence rate whereas preferential use of oral intubation (90%) and of NIV (84%) and use of HMEs (82%) were the three with the highest rate. Organization of infection control was consistently self-reported. Disparities among countries were more frequent for specific actions regarding airway management, and even moreso for controversial issues (subglottic drainage, closed-suction systems).ConclusionThis European survey shows a 72% overall adherence rate to VAP prevention measures; with strong agreements between physician and nurses but considerable differences among countries for availability and organization aspects of infection control, providing healthcare authorities with figures for future programs.