A European care bundle for prevention of ventilator-associated pneumonia
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One recent approach to facilitating guideline implementation involves the use of care bundles.
This document presents a care bundle package addressing VAP prevention in an attempt to promote guideline-compliant practices. Uniquely, the development of these care bundles used a formalised methodology to assess the supporting data, based on multi-criteria decision analysis.
The resulting VAP care bundles for prevention were: non-ventilatory circuit changes unless specifically indicated, alcohol hand hygiene, appropriately educated and trained staff, incorporation of sedation control and weaning protocols into patient care, and oral care with clorhexidine.
Adoption of these care bundles should rationalise VAP prevention practises and improve outcomes, such as length of stay.
KeywordsVentilator-associated pneumonia Care bundles Prevention
Feeding analgesia sedation thromboembolic ulcer glucose
Intensive care medicine
Multi-criteria decision analysis
Clinical Pulmonary Infection Score
American Thoracic Society
Infectious Disease Society of America
British Society for Antimicrobial Chemotherapy
Society of Healthcare Epidemiologists of America
The European VAP care bundle meetings were supported by an unrestricted grant from Wyeth International. Dr Rello's contribution is supported in part by a grant from Instituto Salut Carlos III (FISS 06/0060). Wyeth International had no control over and did not comment on the study design or the methods chosen, analysis of results, interpretation of findings or drafting the paper. One representative attended, observing and listening, without participating in the investigators’ discussions. We thank J. Eastgate for assisting with manuscript preparation of the first draft of the manuscript. J. Eastgate received compensation from Wyeth International. A. Pares (Tarragona, Spain) assisted with the final draft of the manuscript. She is funded by CIBERes.
Conflicts of interest statements
RM has received speaker honoraria from Astra Zeneca and Wyeth; JR has received speaker honoraria and/or research funding from Pfizer, Johnson & Johnson, Merck, Astra Zeneca and Wyeth. He is a member of the advisory boards of Johnson & Johnson, Pfizer and Wyeth Pharmaceuticals; MS has received speaker honoraria and/or research funding from Pfizer, Roche Diagnostics, Becton-Dickinson, Chiron-Novartis, Wyeth, Astra Zeneca, Johnson & Johnson, GeneOhm and BioMérieux. He has served on advisory boards for Pfizer, Chiron-Novartis, Wyeth, Johnson & Johnson, Glaxo-SmithKline and 3M, and is a member of the Glaxo-SmithKline-supported Belgian Sanford Guide Working Party on Antimicrobial Therapy and their Infectious Diseases Advisory Board; JC serves on the Nektar advisory board and has received speaker honoraria from Pfizer, Astra Zeneca, Wyeth, Pharm-Olam, and Brahms; GC has received speaker honoraria from Pfizer, Wyeth, Merck and Glaxo-SmithKline; HL has received speaker honoraria research funding and/or consulting fees from Bayer, Pfizer, Sanofi-Aventis, Wyeth, Johnson & Johnson, Intermune, and Daiichi and Astellas; HG has received speaker honoraria and/or research funding from Wyeth, Glaxo-SmithKline, Pfizer, Merck and Sanofi-Aventis; PD has received speaker honoraria and/or research funding from Pfizer, Wyeth, Glaxo-SmithKline and Boehringer Ingelheim, and is a member of the Johnson & Johnson global anti-infective advisory board; AO, HE, DC and KD have no conflicts of interest to declare. This study, including working meetings and secretarial assistance, was supported by an unrestricted grant from Wyeth International.
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