Application of bundle of prevention of ventilator associated pneumonia in adult intensive care unit: a case study

Abstract

Ventilator-associated pneumonia (VAP) is an infection that affects the pulmonary parenchyma of patients using mechanical fan for more than 48 hours and who have not had the vent as the reason of intubation. The aim of this study is to report the implementation of a Bundle of preventing pneumonia associated with mechanical ventilation (MV) in intensive care unit (ICU)in a hospital in the metropolitan region of Porto Alegre/RS, based on the 5 Million Lives Campaign of Institutes for Healthcare Improvement. It is characterized as a case study, where Hospital Infection Control Service applied in the ICU, a protocol for prevention of ventilator associated pneumonia (Bundle). The aim of this is to reduce the incidence and rate of PAV, establish standardized measures of prevention to reduce the length of stay and minimize hospital costs. Bundle are measures which, when implemented, result in a concomitant reduction in the incidence of adverse events and has better results than imposed individually. This is particularly true when the components interact with each other synergistically or when the partial execution does not achieve the desired result. The intervention described in this case studies contributed to a reduction of Pneumonia associated with the MV and consequently a reduction of deaths of patients undergoing this procedure invasive. The adaptation of this initiative, to fit new measures to the existing standards, showed some resistance to acceptance, reflecting the prerogative of the whole change is difficult, but occurs mainly due to optimism about the potential benefits of process.