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https://hdl.handle.net/11499/8163
Title: | Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: Findings of the International Nosocomial Infection Control Consortium (INICC) | Authors: | Leblebicioglu, H. Yalcin, A.N. Rosenthal, V.D. Koksal, I. Sirmatel, F. Unal, S. Turgut, Hüseyin |
Keywords: | Adult intensive care unit Developing countries Health care acquired infection International Nosocomial Infection Control Consortium Multidimensional approach Ventilator associated pneumonia amikacin ceftazidime imipenem meticillin piperacillin piperacillin plus tazobactam Acinetobacter adult aged antibiotic resistance article bacterium isolation Candida clinical effectiveness clinical practice coagulase negative Staphylococcus controlled study education endotracheal intubation Enterobacter Enterococcus Escherichia coli female hand washing health care personnel human infection control intensive care unit Klebsiella major clinical study male mouth hygiene nasotracheal intubation outcome assessment performance practice guideline prospective study Proteus Pseudomonas Serratia staff training Staphylococcus Staphylococcus epidermidis Stenotrophomonas Streptococcus Turkey (republic) ventilator associated pneumonia Adult Aged Cities Communicable Disease Control Cross Infection Female Guideline Adherence Health Personnel Hospitalization Humans Intensive Care Units Male Middle Aged Pneumonia, Ventilator-Associated Program Evaluation Prospective Studies Turkey |
Abstract: | Purpose: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. Methods: A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. Results: In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) Conclusions: The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey. © 2013 Springer-Verlag Berlin Heidelberg. | URI: | https://hdl.handle.net/11499/8163 https://doi.org/10.1007/s15010-013-0407-1 |
ISSN: | 0300-8126 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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