Preventive bundle approach decreases the incidence of ventilator-associated pneumonia in newborn infants

Pinilla-González, Alejandro; Solaz-García, Álvaro; Parra-Llorca, Anna; Lara-Cantón, Inmaculada; Gimeno, Ana; Izquierdo, Isabel; Vento, Máximo; Cernada, María

OBJECTIVE: We hypothesized that the implementation of evidence-based interventions shaping a bundle approach could significantly reduce the incidence of ventilator-associated pneumonia (VAP) in the neonatal intensive care unit. STUDY DESIGN: We conducted a prospective observational cohort study including neonates undergoing mechanical ventilation >48 h. VAP rate and endotracheal intubation ratio were compared before (pre-period) and after (post-period) applying VAP prevention bundle strategies. RESULT: One hundred seventy-four neonates were included in pre-period (30 months) and 106 in post-period (17 months). Demographic characteristics were comparable and device use ratios were similar. Twenty-eight VAP episodes were diagnosed, 25 in the first period and 3 after the implementation of prevention bundle. This represents a reduction in the incidence rate from 11.79 to 1.93 episodes/1000 ventilator days (p < 0.01). CONCLUSION: The implementation of an educational evidence-based program using a bundle approach to prevent VAP has shown a statistically significant reduction in its incidence density.