The Effect of Ventilator-Associated Pneumonia Prevention Bundles on Ventilator-Associated Event Rate in the Intensive Care Units of a Tertiary Care Hospital

Abstract

Background: It has been shown that the incidence of VAP decreases with compliance with ventilator-associated pneumonia (VAP) precautionary bundles. However, the effect of these bundles on the incidence of ventilator-related events (VIO) is still controversial. The aim of this study is to investigate the incidence of VIO and compliance with the VAP prevention bundle in a certain period in the in-tensive care units (ICU) of a training and research hospital. Materials and Methods: This is a prospective observational case-control study investigating the inci-dence of VIO and compliance with VAP prevention bundles between April and June 2019 in ICUs of a tertiary education and research hospital. VAP prevention bundle created; The incidence of VIO was determined according to the 2013 United States Centers for Disease Control and Prevention (CDC) surveillance criteria. The effects of patient characteristics and distribution of patients in ICUs on the development of VIO were investigated. Results: The study was completed with 98 patients. It was determined that the rate of compliance with VAP prevention bundles varied between 65% and 85% among ICUs. It has been shown with other important risk factors that every 10% decrease in compliance with the VAP prevention bundle increases the risk of developing VIO. Conclusions: According to the 2013 CDC criteria, the incidence of VIO in the ICUs of our hospital is 20.4%. The risk of developing VIO increases with low compliance with the VAP prevention bundle, patient characteristics, and many factors arising from ICU treatments. Differences in ICUs in terms of compliance with VIP measure bundles show the necessity of training activities on the subject.

Bir Üçüncü Basamak Hastanenin Yoğun Bakım Ünitelerinde Ventilatör İlişkili Pnömoni Önleme Demetlerinin Ventilatör İlişkili Olay Oranlarına Etkisi

Öz

Amaç: Ventilatör ilişkili pnömoni (VİP) önlem demetlerine uyum ile VİP insidansının azaldığı gösterilmiştir. Ancak bu demetlerin Ventilatör ilişkili olay (VİO) insidansına olan etkisi hala tartışmalıdır. Bu çalışmanın amacı, bir eğitim araştırma hastanesinin yoğun bakım ünitelerinde (YBÜ) belirli bir dönemdeki VİO insidansı ve VİP önleme demetine uyumun araştırılmasıdır. Materyal ve metod: Bu çalışma, üçüncü basamak bir eğitim ve araştırma hastanesinin YBÜ’ lerinde Nisan - Haziran 2019 arasında VİO insidansı ve VİP önleme demetlerine uyumun araştırıldığı prospektif gözlemsel bir vaka kontrol çalışmasıdır. VİP önleme demeti oluşturuldu; VİO insidansı ise 2013 Amerika Birleşik Devletleri Hastalık Kontrol ve Önleme Merkezi (CDC) sürveyans kriterlerine göre belirlendi. Hasta özelliklerinin ve YBÜ’ lerdeki hasta dağılımının ve VİO gelişimi üzerine etkileri araştırıldı. Bulgular: Araştırma 98 hasta ile tamamlandı. VİP önleme demetlerine uyum oranının YBÜ’ ler arasında %65 ile %85 arasında değiştiği saptandı. VİP önleme demetine uyumdaki her %10 azalmanın VİO gelişme riskini artırdığı diğer önemli risk faktörleri ile gösterildi. Sonuç: Hastanemiz YBÜ’ lerinde 2013 CDC kriterlerine göre VIO insidansı %20,4’tür. VIO gelişme riski, VİP önleme demetine düşük uyum, hasta özellikleri ve YBÜ tedavilerinden kaynaklanan birçok faktör ile artmaktadır. YBÜ’ lerinde VİP önlem demetlerine uyum bakımından farklılıklar konu ile ilgili eğitim faaliyetlerinin gerekliliğini göstermektedir.

Anahtar Kelimeler

• Ventilatör ilişkili pnömoni
• ventilatör ilişkili olay
• önlem demeti
• sürveyans

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