Background: Ventilator-associated pneumonia (VAP) is a significant nosocomial infection (NI) that contributes to patient morbidity and mortality. This study aimed to evaluate the impact of collaborative project on reducing VAP.
Methods: During the project, VAP surveillance and prevention were strengthened among 18 participating hospitals. The VAP prevention activities emphasized were placing ventilated patients in a semirecumbent position unless contraindicated, hand hygiene, oral care practices and disinfection of respiratory care equipment. Data were collected among mechanically ventilated patients admitted to the Intensive Care Units (ICU) from May 2004 to February 2005 by Infection Control Nurses (ICN) and trained ICU staff. VAP was diagnosed using pneumonia definition criteria of the National Nosocomial Infection Surveillance System (NNIS) of the Centers for Disease Control and Prevention (CDC) and was confirmed by attending physicians. Data were analyzed using descriptive statistics and Poisson regression.
Results: Data covered 3002 patients with 28413 ventilator-days. VAP occurred in 358 patients with an overall VAP incidence density rate of 12.6 per 1000 ventilator-days (95% CI 11.3-13.9). During the five 2-month periods, the VAP rate had a significantly decreasing trend ranging from 15.9 to 9.9 per 1000 ventilator-days (p<0.01). The overall mortality rate and case-fatality rate were 3.2 per 100 mechanically ventilated patients and 27.1 per 100 VAP cases, respectively. These two rates did not substantially change during each period. The cost of treatment per one ventilated patient had a significantly decreasing trend (p = 0.02).
Conclusions: The collaborative intervention has significantly reduced VAP rates.