scholarly journals The adherence of the multi-professional team to preventive measures of ventilator-associated pneumonia

2021 ◽  
Vol 10 (13) ◽  
pp. e424101321554
Author(s):  
Angela Maria Chastay ◽  
Janaini Brunoski ◽  
Arthur Garani Narciso ◽  
Elder Dalazoana Filho ◽  
João Pedro Gambetta Polay ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Medical Records ◽  
Healthcare Professionals ◽  
Preventive Measures ◽  
Ventilator Associated Pneumonia ◽  
Reducing Costs ◽  
Gathering Data

Objective: The main purpose of this paper was to evaluate the incidence of Ventilator-Associated Pneumonia (VAP) in an Intensive Care Unit (ICU) and the adherence of the bundles by healthcare professionals. Methodology: This study was prospective, observational, and quantitative, performed in an ICU located in Ponta Grossa (Paraná, Brazil) gathering data from December 2018 to February 2019 through medical records and bedside observations. Results: This study included 56 patients, of whom 3 acquired VAP. The multi-professional team performed several procedures that met the prevention bundles in that UCI, writing them down in medical records, but some of them were not being applied in practice or were not performed properly, exposing divergences between annotations and bedside observations. Conclusion: It is noted that bundles are effective in preventing VAP, reduces risks of HAI and, consequently, deaths. However, there is a need to guide the applicability and registration by the multidisciplinary team, optimizing the adherence of these measures, in order to improve the quality of health of patients and reducing costs and the length of stay in the ICU related to VAP.

scholarly journals Cuidados multiprofissionais relacionados à prevenção da pneumonia associada à ventilação mecânica

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Janaina Souza de Liz ◽  
Pollyana Bortholazzi Gouvea ◽  
Adriano Da Silva Acosta ◽  
Juliana Vieira de Araújo Sandri ◽  
Dagoberto Mior de Paula ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Preventive Measures ◽  
Physical Therapist ◽  
Ventilator Associated Pneumonia ◽  
Prevention Measures ◽  
Multiprofessional Team ◽  
Team Working

Objetivo: Conhecer a percepção da equipe multiprofissional acerca dos cuidados relacionados às medidas de prevenção a pneumonia associada à ventilação mecânica. Método: Tratou-se de um estudo descritivo, qualitativo em que participou a equipe multiprofissional atuante em UTI. Resultados: Totalizaram 20 profissionais. Verificou-se que a equipe multiprofissional conhece algumas medidas preventivas, no entanto a enfermagem percebe o fisioterapeuta como protagonista neste processo. Conclusões: A pesquisa permitiu identificar a maneira como cada membro da equipe percebe a sua atuação e a atuação do outro.Palavras-chave: Infecção Hospitalar; Enfermagem; Controle de Infecções Objective: To know the perception of the multidisciplinary team about the care related to the prevention measures against ventilator-associated pneumonia. Method: This was a descriptive and qualitative study in which the multiprofessional team working in Intensive Care Unit participated. Results: Totaled 20 professionals. It was found that the multiprofessional team knows some preventive measures, however nursing refers to the physical therapist as a protagonist in this process. It was also noticed that the nurse has a fundamental role in maintaining care before the multiprofessional team. Conclusions: The study showed that the multiprofessional team demonstrates knowledge about the preventive measures related to ventilator-associated pneumonia, as well as the professionals seek to act continuously to improve the quality of care, aiming to ensure patient safety.Descriptors: Hospital Infection; Nursing; Infection Control. Objetivo: Conocer la percepción del equipo multidisciplinario sobre la atención relacionada con las medidas de prevención contra la neumonía asociada al ventilador. Método: Este fue un estudio descriptivo y cualitativo en el que participó el equipo multiprofesional que trabajaba en la Unidad Intensiva. Resultados: totalizaron 20 profesionales. Se encontró que el equipo multiprofesional conoce algunas medidas preventivas, sin embargo, la enfermería se refiere al fisioterapeuta como protagonista en este proceso. También se notó que la enfermera tiene un papel fundamental en el mantenimiento de la atención ante el equipo multiprofesional. Conclusiones: El estudio mostró que el equipo multiprofesional demuestra conocimiento sobre las medidas preventivas relacionadas con la neumonía asociada al ventilador, así como que los profesionales buscan actuar continuamente para mejorar la calidad de la atención, con el objetivo de garantizar la seguridad del paciente.Descriptores: infección hospitalaria; Enfermería; Control de infecciones.

scholarly journals Among Trauma Patients, Younger Men with Ventilator-Associated Pneumonia Have Worse Outcomes Compared to Older Men—An Exploratory Study

Healthcare ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 67
Author(s):  
Duraid Younan ◽  
Sarah Delozier ◽  
Nathaniel McQuay ◽  
John Adamski ◽  
Aisha Violette ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Older Men ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Icu Stay ◽  
Younger Men

Background: Ventilator-associated pneumonia is associated with significant morbidity. Although the association of gender with outcomes in trauma patients has been debated for years, recently, certain authors have demonstrated a difference. We sought to compare the outcomes of younger men and women to older men and women, among critically ill trauma patients with ventilator-associated pneumonia (VAP). Methods: We reviewed our trauma data base for trauma patients with ventilator-associated pneumonia admitted to our trauma intensive care unit between January 2016 and June 2018. Data collected included demographics, injury mechanism and severity (ISS), admission vital signs and laboratory data and outcome measures including hospital length of stay, ICU stay and survival. Patients were also divided into younger (<50) and older (≥50) to account for hormonal status. Linear regression and binary logistic regression models were performed to compare younger men to older men and younger women to older women, and to examine the association between gender and hospital length of stay (LOS), ICU stay (ICUS), and survival. Results: Forty-five trauma patients admitted to our trauma intensive care unit during the study period (January 2016 to August 2018) had ventilator-associated pneumonia. The average age was 58.9 ± 19.6 years with mean ISS of 18.2 ± 9.8. There were 32 (71.1%) men, 27 (60.0%) White, and 41 (91.1%) had blunt trauma. Mean ICU stay was 14.9 ± 11.4 days and mean total hospital length of stay (LOS) was 21.5 ± 14.6 days. Younger men with VAP had longer hospital LOS 28.6 ± 17.1 days compared to older men 16.7 ± 6.6 days, (p < 0.001) and longer intensive care unit stay 21.6 ± 15.6 days compared to older men 11.9 ± 7.3 days (p = 0.02), there was no significant difference in injury severity (ISS was 22.2 ± 8.4 vs. 17 ± 8, p = 0.09). Conclusions: Among trauma patients with VAP, younger men had longer hospital length of stay and a trend towards longer ICU stay. Further research should focus on the mechanisms behind this difference in outcome using a larger database.

scholarly journals Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053610
Author(s):  
Ana Cristina Castro-Ávila ◽  
Catalina Merino-Osorio ◽  
Felipe González-Seguel ◽  
Agustín Camus-Molina ◽  
Jaime Leppe
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Cognitive Functioning ◽  
Healthcare Professionals ◽  
Cognitive Impairments ◽  
Anxiety And Depression ◽  
Icu Discharge

IntroductionThe ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.Methods and analysisProspective, multicentre, mixed-methods cohort study in seven Chilean ICUs. Sample: 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment–blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals.Ethics and disseminationThe study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020–78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.Trial registration numberNCT04979897.

The Effect of a Critical Pathway on Patients’ Outcomes After Carotid Endarterectomy

2002 ◽  
Vol 11 (3) ◽  
pp. 250-258 ◽  
Author(s):  
Daleen Aragon ◽  
Virginia Burton ◽  
Jacqueline F. Byers ◽  
Michael Cohen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Carotid Endarterectomy ◽  
Diagnostic Procedures ◽  
Critical Pathway ◽  
Lengths Of Stay ◽  
Implementation Costs

• Background In 1996, an integrated plan of care was implemented to improve quality of care for patients undergoing elective carotid endarterectomy. Goals were to reduce length of stay, costs, number of preoperative and intensive care unit admissions, and use of diagnostic procedures yet maintain good outcomes.• Objectives To determine whether use of the integrated plan of care met the goals.• Methods Data on financial and process outcomes, use of angiographic diagnostic procedures, and demographics were retrieved from the hospital’s database for all patients who had elective carotid endarterectomy without cerebral infarction.• Results A total of 783 patients met inclusion criteria: 129 before implementation of the plan of care, 66 during the 6-month transition, and 588 after implementation. Preoperative angiography was done in 32% of patients before implementation, 11% during the transition, and 4% after implementation. Percentages of patients admitted to the intensive care unit were 77% before implementation, 24% during transition, and 9% after implementation. Mean lengths of stay were 2.93 days before implementation, 2.12 days during transition, and 1.68 days after implementation. Costs per case were $7798 before implementation, $5750 during transition, and $5387 after implementation. Analysis of variance revealed significant differences between groups in total length of stay (P=.001), preoperative length of stay (P&lt;.001), and costs (P&lt;.001).• Conclusion Use of the integrated plan of care reduced length of stay, costs, admissions to intensive care units, and use of cerebral angiography. Use of the plan improved resource utilization while maintaining quality of care.

scholarly journals Multimodality respiratory physiotherapy reduces mortality but may not prevent ventilator-associated pneumonia or reduce length of stay in the intensive care unit: a systematic review

2018 ◽  
Vol 64 (4) ◽  
pp. 222-228 ◽  
Author(s):  
Diana P Pozuelo-Carrascosa ◽  
Ana Torres-Costoso ◽  
Celia Alvarez-Bueno ◽  
Iván Cavero-Redondo ◽  
Purificación López Muñoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Respiratory Physiotherapy

scholarly journals Reducing Length of Stay and Improving Quality of Care by Implementation of Informatics System and Care Bundle in the Intensive Care Unit

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Yang Kai-Hsuan ◽  
Wei-Fong Kao ◽  
Lin Yen-Kuang ◽  
Wang Pei-Ling ◽  
Huang Tsung-Jen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Care Bundle ◽  
Informatics System

Aspectos Multiprofissionais da atuação na Pneumonia associada a ventilação Mecânica - PAVM

2020 ◽  
Author(s):  
Flávio Marques Lopes ◽  
Lívia Pinheiro Siqueira ◽  
Dayanne Alves Pinheiro Silva ◽  
Liana Lima Vieira ◽  
Luciana Carvalho Silveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Lung Disease ◽  
Multidisciplinary Team ◽  
Preventive Measures ◽  
Lung Infection ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Hospital Stays

Ventilator-associated pneumonia (VAP) is the most often lung infection that occurs in the Intensive Care Unit (ICU) and is characterised, specifically, for its development in the first 48 hours after the beginning of Mechanical Ventilation (MV). This kind of lung disease is also associated with longer hospital stays and higher treatment costs. Around 55% of VAPs can be prevented through interventions, scientifically proven, that turns the treatment more viable, effective and at lower costs compared to convencional treatment. The multidisciplinary team is essential in the care of the ICU patient, as it works in the maintenance of patient’s vital organic functions, therefore, in an integrated way, the professionals works to minimize the damage caused by Mechanical Ventilation (MV) in ICU patients, in particular, regarding VAP. The use of measures or bundles are able to decentralize conducts and change the focus of treatment, transforming it into treatment optimised of preventive approaches that avoids complications. Lastly, the preventive measures of VAP should be put into practice, essentially by the multidisciplinary team, aiming at a directly impact on the reduction of the rates of this specific type of pneumonia.

Sign in / Sign up

Export Citation Format

Share Document