Ondokuz Mayis University Medical School, Samsun, Turkey.
Infection. 2013 Apr;41(2):447-56. doi: 10.1007/s15010-013-0407-1. Epub 2013 Jan 26.
To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey.
A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach.
In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.)
The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.
评估国际医院感染控制联盟（INICC）多维方法对土耳其 10 个城市 10 家医院的 11 个重症监护病房（ICU）中成人患者呼吸机相关性肺炎（VAP）发病率降低的影响。
采用前瞻性主动前后对照研究，确定 INICC 多维方法对 VAP 发病率的影响。该研究分为两个阶段。在第一阶段，使用疾病控制和预防中心国家卫生安全网络和 INICC 方法，对 VAP 进行主动前瞻性监测。在第二阶段，我们实施了 VAP 的多维方法。INICC 多维方法包括以下措施：（1）感染控制干预措施包，（2）教育，（3）结果监测，（4）过程监测，（5）VAP 率反馈，（6）感染控制实践绩效反馈。我们比较了每个阶段获得的 VAP 率。进行时间序列分析评估我们方法的影响。
在第一阶段，我们记录了 2376 个机械通气（MV）日，在第二阶段，实施多维方法后，我们记录了 28181 个 MV 日。第一阶段 VAP 发病率为每 1000 MV 日 31.14 例，第二阶段为每 1000 MV 日 16.82 例，VAP 发病率降低 46%（RR，0.54；95%CI，0.42-0.7；P 值，0.0001）。
INICC 多维方法与土耳其这些成人 ICU 中 VAP 发病率的显著降低相关。
