Prevention of ventilator-associated pneumonia in intensive care units : an international online survey
Lambert, Marie-Laurence (Scientific Institute of Public Health (Brussel·les, Bèlgica))
Palomar Martínez, Mercedes (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Agodi, Antonella (University of Catania (Catània, Itàlia))
Hiesmayr, Michael (Medical University of Vienna)
Lepape, Alain (University hospital (Lió, França))
Ingenbleek, Anne (Scientific Institute of Public Health (Brussel·les, Bèlgica))
Palencia Herrejon, Eduardo (Hospital Universitario Infanta Leonor)
Blot, Stijn (Ghent University (Gant, Bèlgica))
Frank, Uwe (Heidelberg University Hospital (Alemanya))

Data:	2013
Resum:	Background: On average 7% of patients admitted to intensive-care units (ICUs) suffer from a potentially preventable ventilator-associated pneumonia (VAP). Our objective was to survey attitudes and practices of ICUs doctors in the field of VAP prevention. Methods: A questionnaire was made available online in 6 languages from April, 1st to September 1st, 2012 and disseminated through international and national ICU societies. We investigated reported practices as regards (1) established clinical guidelines for VAP prevention, and (2) measurement of process and outcomes, under the assumption "if you cannot measure it, you cannot improve it"; as well as attitudes towards the implementation of a measurement system. Weighted estimations for Europe were computed based on countries for which at least 10 completed replies were available, using total country population as a weight. Data from other countries were pooled together. Detailed country-specific results are presented in an online additional file. Results: A total of 1730 replies were received from 77 countries; 1281 from 16 countries were used to compute weighted European estimates, as follows: care for intubated patients, combined with a measure of compliance to this guideline at least once a year, was reported by 57% of the respondents (95% CI: 54-60) for hand hygiene, 28% (95% CI: 24-33) for systematic daily interruption of sedation and weaning protocol, and 27% (95%: 23-30) for oral care with chlorhexidine. Only 20% (95% CI: 17-22) were able to provide an estimation of outcome data (VAP rate) in their ICU, still 93% (95% CI: 91-94) agreed that "Monitoring of VAP-related measures stimulates quality improvement". Results for 449 respondents from 61 countries not included in the European estimates are broadly comparable. Conclusions: This study shows a low compliance with VAP prevention practices, as reported by ICU doctors in Europe and elsewhere, and identifies priorities for improvement.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Healthcare associated infection ; Ventilator-associated pneumonia ; Patient safety ; Preventive measures ; Quality of care
Publicat a:	Antimicrobial resistance and infection control, Vol. 2, N. 9 (March 2013) , p. 1-8, ISSN 2047-2994

DOI: 10.1186/2047-2994-2-9
PMID: 23531169

8 p, 191.4 KB

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