Effect of an Educational Intervention on the Management

Posted by James

INTRODUCTION

Ventilator-associated pneumonia, defined as т pneumonia that arises more than 48-72 h after endotracheal intubation, occurs in 9% to 27% of all patients who have been intubated. This condition prolongs time on the ventilator and length of stay in the intensive care unit (ICU) and in the hospital after discharge from the ICU.1 It accounts for approximately half of all infections in the ICU and is a major reason for the use of antibiotics in the ICU. Previous studies have demonstrated that adequate empiric antibiotic therapy, as well as timely initiation of therapy, is associated with lower rates of in-hospital mortality and morbidity and lower costs.

Publication of a set of guidelines for managing the care of adults with ventilator-associated and other types of pneumonia1 prompted an evaluation of the manage­ment of ventilator-associated in the ICU at the authors’ hospital. The guidelines provide recommendations on selection of empiric antibiotic therapy, as well as dosing, route of administration, timing, de-escalation according to culture results, and duration of therapy. Because the guidelines’ recommendations on empiric antibiotic therapy may not be applicable for local use, due to differences in local microbiological data, it was important to identify the types of bacterial pathogens associated with ventilator-associated pneumonia at our institution. An educational intervention was undertaken in which patient outcomes after management of ventilator-associated pneumonia in the ICU, along with targeted recommendations for improving management, were shared with ICU physicians. The objective of the study reported here was to evaluate the management of this type of pneumonia in the ICU before and after the intervention and to determine the local microbiologic data for ventilator-associated pneumonia in this ICU. levitra 10 mg