Effects of a Ventilator-associated Pneumonia Prevention Program on Incidence Rate and Endotracheal Colonization

Ui Rim Song; Sook Young Kim

doi:10.7475/kjan.2016.28.6.628

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Song and Kim: Effects of a Ventilator-associated Pneumonia Prevention Program on Incidence Rate and Endotracheal Colonization

Original Article

Korean Journal of Adult Nursing 2016; 28(6): 628-636.

Published online: 31 December 2016

DOI: https://doi.org/10.7475/kjan.2016.28.6.628

Effects of a Ventilator-associated Pneumonia Prevention Program on Incidence Rate and Endotracheal Colonization

Ui Rim Song, MSN, RN¹, Sook Young Kim, Ph.D., RN²

¹Nurse, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

²Professor, College of Nursing, CHA University, Pocheon, Korea.

Corresponding author: Kim, Sook Young. College of Nursing, CHA University, 120 Haeryong-ro, Pocheon 11160, Korea. Tel: +82-31-850-9324, Fax: +82-31-8017-5853, kimsy@cha.ac.kr

Received 31 August 2016 Revised 12 December 2016 Accepted 15 December 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care.

Methods

A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group (n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to 30°~45° high, maintaining continuous endotracheal cuff pressure at 25 cm H₂O, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, χ² test, Mantel-Haenszel χ² and Cox proportional harzard regression model.

Results

The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant (χ²=0.79, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group (χ²=14.59, p<.001).

Conclusion

Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.

Keywords: Pneumonia, Ventilator-associated, Respiratory aspiration, Oral hygiene

Figures and Tables

Figure 1

Comparison of endotracheal colonization rates between groups.

Table 1

Ventilator-associated Pneumonia Prevention Program

HOB=head of bed.

Table 2

Homogeneity Test of General and Disease related Characteristics between Two Groups (N=100)

Exp.=experimental group; Cont.=control group; MICU=Medical intensive care unit; CCU=Coronary care unit; GCS=Glasgow coma scale; SAPS=Simplified acute physiology score.

Table 3

Comparison of Ventilator associated Pneumonia Rate between Two Groups (N=100)

Exp.=experimental group; Cont.=control group; VAP=ventilator associated pneumonia.

Table 4

Comparison of the Number of Endotracheal Colonization between Two Groups (N=100)

Exp.=experimental group; Cont.=control group.

Notes

This manuscript is a revision of the first author's master's thesis from CHA University.

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