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Prevention of ventilator-associated pneumonia: the multimodal approach of the Spanish ICU "Pneumonia Zero" program

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dc.contributor.author Álvarez Lerma, Francisco
dc.contributor.author Palomar Martínez, Mercedes
dc.contributor.author Sánchez García, Miguel
dc.contributor.author Martínez-Alonso, Montserrat
dc.contributor.author Álvarez Rodríguez, Joaquín
dc.contributor.author Lorente, Leonardo
dc.contributor.author Arias-Rivera, Susana
dc.contributor.author García, Rosa
dc.contributor.author Gordo, Federico
dc.contributor.author Añón, José M.
dc.contributor.author Jam-Gatell, Rosa
dc.contributor.author Vázquez-Calatayud, Mónica
dc.contributor.author Agra Varela, Yolanda
dc.date.accessioned 2018-05-10T08:16:31Z
dc.date.available 2018-05-10T08:16:31Z
dc.date.issued 2018
dc.identifier.citation Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, Martínez-Alonso M, Álvarez-Rodríguez J, Lorente L. et al. Prevention of ventilator-associated pneumonia: the multimodal approach of the Spanish ICU "Pneumonia Zero" program. Crit Care Med. 2018 Feb;46(2):181-188. DOI: 10.1097/CCM.0000000000002736
dc.identifier.issn 0090-3493
dc.identifier.uri http://hdl.handle.net/10230/34605
dc.description.abstract OBJECTIVES: The "Pneumonia Zero" project is a nationwide multimodal intervention based on the simultaneous implementation of a comprehensive evidence-based bundle measures to prevent ventilator-associated pneumonia in critically ill patients admitted to the ICU. DESIGN: Prospective, interventional, and multicenter study. SETTING: A total of 181 ICUs throughout Spain. PATIENTS: All patients admitted for more than 24 hours to the participating ICUs between April 1, 2011, and December 31, 2012. INTERVENTION: Ten ventilator-associated pneumonia prevention measures were implemented (seven were mandatory and three highly recommended). The database of the National ICU-Acquired Infections Surveillance Study (Estudio Nacional de Vigilancia de Infecciones Nosocomiales [ENVIN]) was used for data collection. Ventilator-associated pneumonia rate was expressed as incidence density per 1,000 ventilator days. Ventilator-associated pneumonia rates from the incorporation of the ICUs to the project, every 3 months, were compared with data of the ENVIN registry (April-June 2010) as the baseline period. Ventilator-associated pneumonia rates were adjusted by characteristics of the hospital, including size, type (public or private), and teaching (postgraduate) or university-affiliated (undergraduate) status. MEASUREMENTS AND MAIN RESULTS: The 181 participating ICUs accounted for 75% of all ICUs in Spain. In a total of 171,237 ICU admissions, an artificial airway was present on 505,802 days (50.0% of days of stay in the ICU). A total of 3,474 ventilator-associated pneumonia episodes were diagnosed in 3,186 patients. The adjusted ventilator-associated pneumonia incidence density rate decreased from 9.83 (95% CI, 8.42-11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22-5.84) after 19-21 months of participation. CONCLUSIONS: Implementation of the bundle measures included in the "Pneumonia Zero" project resulted in a significant reduction of more than 50% of the incidence of ventilator-associated pneumonia in Spanish ICUs. This reduction was sustained 21 months after implementation.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.rights © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.other Pneumònia -- Prevenció
dc.subject.other Pulmons -- Malalties -- Prevenció
dc.title Prevention of ventilator-associated pneumonia: the multimodal approach of the Spanish ICU "Pneumonia Zero" program
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1097/CCM.0000000000002736
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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