Improving adherence to evidence-based practices and promoting teamwork and safety culture can significantly reduce ventilator-associated complications, according to a study published in the journal Critical Care Medicine.
For the study, researchers with the Johns Hopkins Armstrong Institute of Patient Safety and Quality in Baltimore provided training to quality improvement teams across 56 intensive care units in 38 hospitals in Maryland and Pennsylvania. The training initiatives incorporated recommended interventions by the Society for Healthcare Epidemiology of America and the Society of Critical Care Medicine for patients on ventilators and the implementation of the Agency for Healthcare Research and Quality's Comprehensive Unit-based Safety Program.
After 24 months, these training initiatives resulted in a 38 percent reduction in the total number of ventilator-associated events from 7.34 cases per 1,000 patient ventilator days to 4.58 cases. Additionally, the amount of infection-related ventilator complications fell by more than 50 percent and probable ventilator-associated pneumonia cases decreased by 78 percent during the study period.
"When patients are sick, complications can happen, and, in some cases, healthcare-associated infections are thought to be inevitable," said Sean Berenholtz, MD, a faculty member in the Armstrong Institute. "This is the largest study to date to show that these complications of mechanical ventilation, or ventilator associated events, are also preventable."
Approximately 800,000 hospital patients undergo mechanical ventilation annually in the U.S.
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