Bundle Care for Preventing Ventilator-associated Pneumonia at a Medical Center: A Preliminary Report

BackgroundVentilator-associated pneumonia (VAP) is a very common nosocomial infection in intensive care units (ICUs). Ventilator-associated pneumonia occurs in a considerable proportion of patients undergoing mechanical ventilation and is associated with substantial morbidity, mortality, and excess cost. Therefore, strategies that effectively prevent VAP are urgently needed.MethodsPatients admitted between January 1, 2010 and December 31, 2012 were investigated prospectively for VAP. Patients who were admitted to medical and surgical ICUs required more than 48 hours of mechanical ventilation. To develop evidence-based recommendations for VAP bundle care, we organized a multidisciplinary team that included administrators, infection control professionals, clinicians, and nursing informatics specialists. By April 1, 2011, the VAP bundle care interventions were implemented, and integrated into a clinical informatics system for reminding clinicians to promote compliance in bundle care.ResultsAfter implementing VAP bundle care, the incidence of VAP decreased from 1.5% to 0% in both ICUs. The average overall patient-ventilator days were decreased from 1301 person-days per month to 1213 person-days per month in both ICUs.ConclusionBased on our experience, we found that implementing VAP bundle care decreased ventilator days and the incidence of VAP.