成功实施集束化策略预防新生儿重症监护病房呼吸机相关性肺炎
Successful Implementation of a Bundle Strategy to Prevent Ventilator-Associated Pneumonia in a Neonatal Intensive Care Unit.
机构信息
Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care Unit, Ankara, Turkey.
出版信息
J Trop Pediatr. 2018 Jun 1;64(3):183-188. doi: 10.1093/tropej/fmx044.
BACKGROUND
We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit.
METHODS
This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods.
RESULTS
Throughout the study period, 13 VAP episodes were observed. Full adherence to all six components of the bundle doubled in the active-bundle period (12.8 vs. 24.3%, p < 0.01). The mean VAP rate decreased from 7.33/1000 to 2.71/1000 ventilator days following intervention (p = 0.083).
CONCLUSION
This study showed that reliable implementation of a neonate-specific VAP prevention bundle can produce sustained reductions in VAP rates.
背景
我们旨在研究我们开发的循证包对降低呼吸机相关性肺炎（VAP）发生率的有效性，并评估在三级新生儿重症监护病房中该策略的遵守程度。
方法
这项前瞻性队列研究分为两个阶段进行。所有需要通气的新生儿均纳入研究。比较两个阶段的 VAP 发生率、对捆绑包组件的遵守率以及每个捆绑包组件对 VAP 发生率的贡献。
结果
在整个研究期间，观察到 13 例 VAP 发作。在积极捆绑包期间，完全遵守捆绑包的所有六个组件的比例增加了一倍（12.8%对 24.3%，p<0.01）。干预后，VAP 发生率从 7.33/1000 降至 2.71/1000 呼吸机天数（p=0.083）。
结论
本研究表明，可靠实施针对新生儿的 VAP 预防捆绑包可持续降低 VAP 发生率。
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