Recommendations prioritize strategies to prevent ventilator-associated pneumonia

(Press-News.org) CHICAGO (July 16, 2014) – Thousands of critically ill patients on life support develop ventilator-associated pneumonia (VAP) each year. A new document released today by a consortium of professional organizations helps prioritize strategies to prevent this potentially fatal infection.

This guidance, featured in the update of the Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals, is published in the August issue of Infection Control and Hospital Epidemiology and was produced in a collaborative effort led by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission. Included in the guidance are specific recommendations for implementation in acute care facilities for adults, pediatric and neonatal patient populations.

"Because the Compendium consists of guidance documents rather than guidelines, we have flexibility to include recommendations where the formal grading of the quality of evidence is relatively low but where experts agree that the potential benefits outweigh potential risks and costs," said Michael Klompas, MD, MPH, a co-lead author with Sean Berenholtz, MD, MHS. "This is especially important for younger patient populations where evidence is sparse."

The guidance includes basic prevention strategies, as well as special approaches that can be considered for hospitals with VAP rates that are not improving despite high performance rates on basic practices. Also included are common attributes of successfully implemented care improvement programs since accountability is necessary to consistent and effective execution of prevention strategies.

Prevention strategies highlighted by the authors include:

For adult patients: Avoid intubation if possible. Minimize sedation. Assess readiness to extubate daily. Encourage exercise and mobilization. Use endotracheal tubes with subglottic secretion drainage for high risk patients. Elevate the head of the bed.

For pediatric and neonatal patients: Avoid intubation if possible. Minimize the duration of mechanical ventilation. Provide regular oral care (toothbrushing, gauze or sterile water only depending on age). Elevate the head of the bed (pediatric patients only).

The new practice recommendations are a part of Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates, a series of articles sharing evidence-based strategies to help healthcare professionals effectively control and prevent the spread of healthcare-associated infections (HAIs). The 2014 release revises the initial 2008 Compendium publication.

INFORMATION: Michael Klompas, Richard Branson, Eric Eichenwald, Linda Greene, Michael Howell, Grace Lee, MD, Shelley Magill, Lisa Maragakis, Gregory Priebe, Kathleen Speck, Deborah Yokoe, Sean M. Berenholtz. " Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update." Infection Control and Hospital Epidemiology 35:8 (August 2014).

Published through a partnership between the Society for Healthcare Epidemiology of America and The University of Chicago Press, Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

About the Society for Healthcare Epidemiology of America SHEA is a professional society representing more than 2,000 physicians and other healthcare professionals globally with expertise in and passion for healthcare epidemiology and infection prevention. SHEA's mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society promotes science and research, develops expert guidelines and guidance for healthcare workers, provides high-quality education, promotes antimicrobial stewardship, encourages transparency in public reporting related to HAIs, works to ensure a safe healthcare environment, and facilitates the exchange of knowledge. SHEA upholds the value and critical contributions of healthcare epidemiology to improving patient care and healthcare worker safety in all healthcare settings. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.

About the Infectious Diseases Society of America The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 10,000 members, was founded in 1963 and is based in Arlington, VA. For more information, see http://www.idsociety.org.

About the American Hospital Association The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information visit the website at http://www.aha.org.

About the Association for Professionals in Infection Control and Epidemiology APIC's mission is to create a safer world through prevention of infection. The association's more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at http://www.apic.org. Follow APIC on Twitter: http://twitter.com/apic and Facebook: http://www.facebook.com/APICInfectionPreventionandYou. For information on what patients and families can do, visit APIC's Infection Prevention and You website at http://www.apic.org/infectionpreventionandyou.

About The Joint Commission Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 20,000 health care organizations and programs in the United States, including more than 10,300 hospitals and home care organizations, and more than 6,500 other health care organizations that provide nursing and rehabilitation center care, behavioral health care, laboratory and ambulatory care services. The Joint Commission currently certifies more than 2,000 disease-specific care programs, focused on the care of patients with chronic illnesses such as stroke, joint replacement, stroke rehabilitation, heart failure and many others. The Joint Commission also provides health care staffing services certification for more than 750 staffing offices. An independent, not-for-profit organization, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at http://www.jointcommission.org.