National bundle care program implementation to reduce ventilator-associated pneumonia in intensive care units in Taiwan
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
52
Journal Issue
4
Pages
592-597
Date Issued
2019
Author(s)
Kao C.-C.
Chiang H.-T.
Chen C.-Y.
Hung C.-T.
Chen Y.-C.
Su L.-H.
Shi Z.-Y.
Liu J.-W.
Liu C.-P.
Chuang Y.-C.
Ko W.-C.
Chen Y.-H.
Tseng S.-H.
Lee C.-M.
Lu M.-C.
for the Infection Control Society of Taiwan
Abstract
Background/purpose: This study investigated the impact of implementing ventilator-associated pneumonia (VAP) bundle care on the rates of VAP in intensive care units (ICUs) in Taiwan. Methods: A total of 10 ICUs (bed number, 170), including surgical (SICUs) (n = 7), cardiovascular/surgical (CV/S-ICUs) (n = 1), and medical ICUs (MICUs) (n = 2) from 10 hospitals (7 medical center hospitals and 3 regional hospitals) were enrolled in this quality-improvement project. This study was divided into the pre-intervention phase (1st January, 2012–31st July, 2013) and the intervention phase (1st August, 2013–31st October, 2014). Results: Among the 10 hospitals, the overall rates (cases per 1000 ventilator-days) of VAP declined significantly (p = 0.005; rate ratio, 0.71) from 1.9 in the pre-intervention period to 1.5 in the intervention period. Significant difference in VAP rates between these periods was found in the regional hospitals (from 1.6 to 0.7; p < 0.001) and the SICUs (from 2.1 to 1.4; p < 0.001), but not in the medical centers (2.0 vs. 1.9; p = 0.0667) or CV/S-ICUs (4.5 vs. 4.5; p = 0.5391). However, VAP rate increased significantly (cases per 1000 ventilator-days) in the MICUs between the two periods (from 0.5 to 1.0; p = 0.0489). For the VAP bundle care elements, the overall compliance rate was 87.7% with 83.6% and 97.9% in the medical centers and regional hospitals, respectively. Conclusions: Implementing VAP bundle care has effectively reduced VAP in Taiwanese ICUs, but differences in performance and compliance rates of VAP bundle care among the different ICUs and hospital categories did exist. ? 2017
SDGs
Other Subjects
Article; hand washing; health care planning; health program; hospital; human; intensive care unit; major clinical study; patient compliance; prospective study; Taiwan; ventilator associated pneumonia; care bundle; cross infection; infection control; intensive care unit; procedures; ventilator associated pneumonia; Cross Infection; Hospitals; Humans; Infection Control; Intensive Care Units; Patient Care Bundles; Pneumonia, Ventilator-Associated; Prospective Studies; Taiwan
Type
journal article