Incidence of Ventilator-Associated Pneumonia (VAP) After the Institution of an Educational Program on VAP Prevention
Narong Kulvatunyou MD*, Aree Boonbarwornrattanakul MNS**, Yupa Soonthornkit BNS**, Chortip Kocharsanee MSc**, Panuwat Lertsithichai MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Objective : Demonstrate if the institution of an educational program on VAP and its prevention is effective in
helping reduce the incidence of VAP in a surgical ICU.
Materials and Methods : An educational program on VAP and its prevention, which consisted of a 1-hour formal
lecture, an educational handout, and a pre-and post-test exam was given to the nursing staff beginning in
April 1st, 2003. Reminding posters were posted throughout the ICU. The pre-and post-intervention clinical
data that included age, sex, diagnosis, APACHE II, ventilator days, and incidence of VAP were collected. VAP
was considered to have occurred only after the patient had been on mechanical ventilation for greater than 48
hours. The primary outcome measure was the incidence of VAP. The secondary outcome measures were dura-
tion of the ICU and hospital stay, and the ICU and hospital mortality. Values were expressed as mean +
standard deviation, and median (range). Multiple logistic regression analysis of various variables was used
to identify risk factors for the occurrence of the VAP.
Results : Eight-five patients in Pre- (July 1st, 2002 to June 30th, 2003) and 89 patients in post- (July 1st, 2003 to
June 30th, 2004) intervention met the inclusion criteria. The incidence of VAP decreased from 39.7 per 1000
ventilator-day to 10.5 per 1000 ventilator-day (p-value < 0.001) after the institution of an educational
program. The ICU, hospital length of stay, and the mortality rate remained unchanged. Age and the
interventional program were found to correlate with the occurrence of VAP.
Conclusion : An institution of an educational program on VAP and its prevention helps reduce the incidence
of the VAP at the study institution but does not affect the ICU, hospital length of stay, and the mortality rate.
Keywords : Ventilator-associated pneumonia, Education, Intervention
