Cutting back on HAP and VAP during medical procedures
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are serious infections that affect patients who are hospitalized or intubated. They can lead to increased morbidity, mortality, length of stay, and health care costs. Therefore, it is important to implement strategies to prevent and reduce the incidence of these infections.
Prevention strategies for HAP and VAP
According to the Centers for Disease Control and Prevention (CDC), some of the prevention strategies for HAP and VAP include:
– Performing hand hygiene before and after contact with patients and their environment
– Using appropriate personal protective equipment (PPE) when indicated
– Implementing contact precautions for patients with multidrug-resistant organisms (MDROs)
– Cleaning and disinfecting reusable medical equipment between patients
– Educating staff, patients, and visitors about infection prevention practices
– Monitoring and reporting HAP and VAP rates and outcomes
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Additionally, for patients who require mechanical ventilation, the CDC recommends the following interventions:
– Elevating the head of the bed to 30-45 degrees
– Assessing readiness for extubation daily
– Providing oral care with chlorhexidine
– Avoiding gastric overdistension
– Using endotracheal tubes with subglottic suctioning
– Using closed suctioning systems
– Minimizing sedation and using protocols for sedation interruption and weaning
– Implementing ventilator bundles
Benefits of cutting back on HAP and VAP
Cutting back on HAP and VAP can have significant benefits for patients, health care providers, and the health care system. Some of the benefits are:
– Improved patient outcomes and quality of life
– Reduced complications and adverse events
– Decreased length of stay and readmissions
– Lowered antibiotic use and resistance
– Reduced health care costs and resource utilization
Conclusion
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HAP and VAP are preventable infections that can have serious consequences for hospitalized or intubated patients. By implementing evidence-based prevention strategies, health care providers can reduce the risk of these infections and improve patient safety and quality of care.
References
CDC. (2019). Healthcare-associated infections: Pneumonia (ventilator- and nonventilator-associated HAI). Retrieved from https://www.cdc.gov/hai/organisms/pneumonia.html
Klompas, M., Branson, R., Eichenwald, E. C., Greene, L. R., Howell, M. D., Lee, G., … & Speck, K. (2014). Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S133-S154.
Melsen, W. G., Rovers, M. M., Groenwold, R. H., Bergmans, D. C., Camus, C., Bauer, T. T., … & Bonten, M. J. (2013). Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies. The Lancet infectious diseases, 13(8), 665-671.
Muscedere, J., Sinuff, T., Heyland, D. K., Dodek, P. M., Keenan, S. P., Wood, G., … & Cook, D. J. (2008). The clinical impact and preventability of ventilator-associated conditions in critically ill patients who are mechanically ventilated. Chest, 134(5), 951-959.