Abstract
Background
Pneumonia is the second most common healthcare-associated infection worldwide. Non ventilator – Hospital Acquired Pneumonia (NV-HAP) affects more people than VAP, has a comparable mortality rate (18.7% vs. 18.9%), and has higher total costs ($156 million vs. $86 million), respectively. The objective of this study was to describe the result of the implementation of a bundle of measures for the prevention of NV-HAP in adult patients in a University Hospital in Colombia.
Methods
Descriptive study. In a period of 2 years, a care bundle for prevention of NV-HAP was implemented in adult patients in a university hospital that consisted of: (1) identification of patients at risk (patients over 60 years of age, or with altered consciousness, or swallowing disorder, or patients with tracheostomy), (2) marking the patient with a sticker on the head of the bed, and (3) implementation of the following measures: head of the bed elevation to 30°–45°, oral care every 12 hours, chlorhexidine oral rinse decontamination every 12 hours and aspiration of secretions as needed. In the first 6 months, training was carried out for all staff, the monthly adherence to the strategy was measured.
Results
During 2016, 1,045 patients were included, with 10,011 observations, bundle adherence during the first year was 33%. in the second year, 1,400 patiens were included, with 13,198 observations, the bundle adherence increased to 90% throughout the hospital. The rate of NV-HAP decreased from 4.2 (96 cases) to 3.4 (89 cases) per 1,000 patient-days, in the second year compared with the previous intervention year.
Conclusion
The strategy of prevention of NV-HAP decreased the cases of nosocomial pneumonia in a university hospital, through the education a high adherence to the strategy was achieved. Studies with a better design should be done to confirm the findings.
Disclosures
All authors: No reported disclosures.
Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review