Impact of the implementation of a combo of measures for the prevention of pneumonias associated with mechanical ventilation

Abstract

Introduction: Mechanical Ventilator Associated Pneumonia (MAP - MRA) is one of the most frequent healthcare associated infections (HAI) in Intensive Care Units (ICUs). By definition, ventilator-associated pneumonias (VAP) must have developed more than 48 hours after intubation of the patient. Objective: To evaluate the impact of the implementation of the combo of measures for the prevention of ventilator-associated pneumonias in an adult Covid Critical Care Unit of a private sanatorium in the city of San Miguel de Tucumán, province of Tucumán in the period April 2021 to November 2022.Methods: A descriptive, quantitative, field, observational and prospective cross-sectional study was designed. A total of 456 observations were included in the study.Results: Good responses were obtained in relation to this measure. Although there were not satisfactory responses in all months, with each analysis more criteria were applied at the time of evaluating the ventilated patient. Overall compliance with the measures became stronger as of September 2021, having achieved 100% adherence during 3 consecutive months in March, April, May 2022 and later in September and October 2022.Conclusions: it was possible to identify that the most difficult measures to comply with were those that are more related to a medical indication and evaluation, such as the promotion of NIV, daily suspension of sedation and the spontaneous ventilation test. Despite not yet reaching the goal of 95% adherence in a sustained manner, the rates of ventilator-associated pneumonias fluctuated downward as the measures implemented were complied with.