The Effect of Bundle Implementation in Reducing of Ventilator-Associated Pneumonia Rates in Intensive Care Patients

Abstract

Background: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in mechanically ventilated patients. Effects of VAP in death rates, in extending the average duration of hospitalization and cost created the need to implement a bundle. Aim: To investigate the relationship between the application of IHI and HPS bundle and VAP rates in ICU adult patients. Material and Method: A critical review of research articles was made, using the electronic databases Medline, Cochrane and HEAL-Link, and the Google Scholar, with the key words: ventilator-associated pneumonia, VAP bundle, ventilator bundles, VAP prevention, mechanical ventilation, device related infections. The inclusion criteria were the English language, the research design, focus on VAP and conduct of investigation in adult patients (>18 years old). The chronological searching period of bibliography was between 2006 and 2016. The sample was finally 8 primary research articles, of which 75% referred to patients who are hospitalized in medical/surgical ICU. Results: The data analysis showed that VAP rates decreased from 39% to 100% in all places that applicate the bundle. In cases where the compliance of personnel due to the bundle was high (>80%), VAP decreased to 100% after bundle implementation (p<0,001). Conclusions: Implementation of the bundle in various types of adult ICU (surgical, medical, mixed) in conjunction with high compliance of personnel lead to reduction of VAP in ICU patients.