Korean J Adult Nurs.  2016 Dec;28(6):628-636. 10.7475/kjan.2016.28.6.628.

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

Affiliations
  • 1Nurse, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 2Professor, College of Nursing, CHA University, Pocheon, Korea. kimsy@cha.ac.kr

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 Hâ‚‚O, 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, x² test, Mantel-Haenszel x² 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 (x²=0.79, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group (x²=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.


MeSH Terms

Chlorhexidine
Colon*
Coronary Care Units
Head
Humans
Incidence*
Intensive Care Units
Intubation, Intratracheal
Nursing
Oral Hygiene
Pneumonia
Pneumonia, Ventilator-Associated*
Respiratory Aspiration
Suction
Chlorhexidine

Figure

  • Figure 1 Comparison of endotracheal colonization rates between groups.


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