The Effect Of Comprehensive Intervention Measures On The Incidence Of Ventilator Associated Pneumonia In ICU

Objective: To evaluate of comprehensive intervention measures on ventilator-associated pneumonia(VAP) in intensive care unit(ICU), in order to reduce the VAP incidence and provide clinical reference.Methods: Retrospective analysis of Fengfeng Group General Hospital from January 2013 to December 2014. The patients(n=628) clinical data of with mechanical ventilation were collected. The patients were divided into two groups: strengthen intervention group(from January 2014 to December 2014) and control group(from January 2013 to December 2013). In the control group, the monitoring method was conducted to record the severe ICU VAP rate, while in the strengthen intervention group, comprehensive intervention strategies for VAP prevention was conducted. Comprehensive intervention strategies:(1) cut off the route of exogenous transmission.(2) reduce the mechanical ventilation time, active treating primary disease of patients, daily assessment.(3) prevent the spread of bacteria colonization: strengthen the position management according to the patient’s actual situation; bed head elevation 30 degrees to 45 degrees, the head keep one side; oral care in routine.(4) emphasize the airway management: control the suction time and skills; good airway humidification; emphasize the management of the air bag.(5) increase immune defense ability, reasonable application of antibiotics. The VAP incidence rate was compared in the two groups. SPSS 17.0 statistical software was used to analyze measurement data. in χ2 test. P<0.05 was statistical difference.Results:1 The mechanical ventilation comparison in the two groups: 628 patients, 7764 hospital day, 2102 mechanical ventilation days, mechanical ventilation rate 27.07%. In the control group in 2013, there were 312 patients with 3862 days of hospitalization, 1034 mechanical ventilation days, and mechanical ventilation rate 26.77%. In the strengthen intervention group in 2014, there were 316 patients with 3902 days of hospitalization, 1068 mechanical ventilation days and mechanical ventilation rate 27.37%. There was no significant difference between the two groups(P>0.05).2 The VAP incidence rate: A total of 106 patients who developed to VAP with 2102 ventilator days. From 2013 to 2014, the VAP incidence rate was 50.43 cases / 1000 ventilator days. In the control group, there were 69 VAP cases and the incidence of VAP was 66.73 cases per 1000 ventilator days(66.73 per thousand). In the strengthen intervention group, there were 37 VAP cases and the incidence of VAP was 34.64 / 1000 patients with mechanical ventilation day(34.64 per thousand). The results showed that the VAP rate in the strengthen intervention group in 2014 was lower than that in the control group in 2013. There was significant difference between THEtwo groups(x2=9.66, P < 0.05).Conclusion: The monitoring and comprehensive intervention measures about VAP target prevention can reduce the incidence VAP rate in ICU.