A multifaceted program to prevent ventilator-associated pneumonia: Impact on compliance with preventive measures

Abstract

Objective: To determine the effect of a 2-yr multifaceted program aimed at preventing ventilator-acquired pneumonia on compliance with eight targeted preventive measures. Design: Pre-and postintervention observational study. Setting: A 20-bed medical intensive care unit in a teaching hospital. Patients: A total of 1649 ventilator-days were observed. Interventions: The program involved all healthcare workers and included a multidisciplinary task force, an educational session, direct observations with performance feedback, technical improvements, and reminders. It focused on eight targeted measures based on well-recognized published guidelines, easily and precisely defined acts, and directly concerned healthcare workers' bedside behavior. Compliance assessment consisted of five 4-wk periods (before the intervention and 1 month, 6 months, 12 months, and 24 months thereafter). Measurements and Main Results: Hand-hygiene and glove-and-gown use compliances were initially high (68% and 80%) and reMained stable over time. Compliance with all other preventive measures was initially low and increased steadily over time (before 2-yr level, p