The Impact of VAP Staff Education on VAP Morbidity and Mortality in Alexandria University.
Staff education had several success stories in reducing Ventilator-associated Pneumonia rate. However, the stability of supplies and the top management support were not addressed in most of these studies.
In addition, both were considered essential in several reviews. To determine the efficiency and efficacy of VAP staff education with deficient supplies and lack of top management support.
Quasi-experimental study with before and after prospective cohort in two medical/surgical ICUs of Alexandria university affiliated hospitals during the period from September 2007 till May 2013. The intervention phase included the provision of supplementary supplies, interactive education for physicians and nurses followed by a VAP campaign. All VAP episodes not only the first one was included.
A total of 598 patients were enrolled in the study. The adherence to expanded VAP bundle significantly increased in the post-intervention phase as follows; head of bed elevation, oral care, daily sedation vacation, daily assessment of weaning, peptic ulcer prophylaxis, DVT prophylaxis, cuff pressure measurement, and hand hygiene.
The VAP rate decreased significantly by 35% with p= 0.002 and CI 9.73-37.15 in spite of significant increase of the ventilator utilization ratio in the post-intervention phase. The MV, antibiotic and ICU days did not change significantly in the post-intervention phase. The distribution of organisms did not differ significantly between both groups.
The sensitivity of most of carbapenems and β-lactam/βlactamase inhibitors to Acinetobacter, Klebsiella and Pseudomonas decreased significantly in the post intervention phase whereas the sensitivity of vancomyicin to Staphylococcus aureus
remained the same.
Pulm Res Respir Med Open J. 2014; 1(1): 32-45. doi: 10.17140/PRRMOJ-1-105
