Education to prevent ventilator-associated pneumonia in intensive care unit - Revista Brasileira de Enfermagem

INTRODUCTION

Ventilator-Associated Pneumonia (VAP) is one of the complications related to the care of patients hospitalized in the Intensive Care Unit (ICU), which, according to consulted authors, exceeds the mortality rates of other Healthcare Related Infections (HRI). VAP is the second most frequent infection in patients admitted to the ICU, as well as the most prevalent in patients who require invasive respiratory support. The length of stay in the ICU for patients who developed VAP is 15.7±9.1 days versus 4.9±4.9 for those who were not affected, with mortality rates of 32% attributed to this infection. The impact of VAP can also be seen in the length of time of Mechanical ventilation (MV), with a difference of 14.3±15.5 days of MV for patients who developed the infection, compared to 4.7±7.0 days of V of those without pneumonia.

Protocols can be used to prevent HRI, such as the VAP prevention bundle, which consists of a small grouping of the main evidence-based multidisciplinary practices to be used in a multidisciplinary way in Intensive Care^–. Preventive measures, when applied together, will result in better outcomes than when implemented individually. However, when there is any medical contraindication to apply a certain preventive measure in the bundle, it should be considered as performed and not as a failure to apply the protocol; thus, the bundle is considered to be complete. Preventive measures are related to the drop in infection rates, reaching a reduction from 8.6 VAP/1000 ventilator days to 2.0 VAP/1000 ventilator days. The use of bundle to prevent VAP can contribute to reducing the number of days in the ICU, from 36 days to 27 days of stay. Preventive actions are low-cost measures that can be easily applied, such as: headboard elevation between 30° and 45°, oral hygiene with 0.12% mouthwash chlorhexidine, mechanical teeth brushing, endotracheal tube pressure evaluation and ventilator filter position.

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