Investigation of Compliance With Ventilator-Associated Pneumonia Prevention Methods and Incidence of Ventilator-Associated Pneumonia in Intensive Care Units

Ventilator-associated Pneumonia (VAP) is a high-mortality hospital infection that occurs in patients undergoing invasive Mechanical Ventilation (MV) and is frequently encountered in intensive care units. Prolonged mechanical ventilation, prolonged hospitalizations, excessive use of antibiotics and increased medical costs are seen. Therefore, compliance with ventilator-associated pneumonia prevention methods is becoming increasingly important. Therefore, in the investigator's study was to investigate compliance with ventilator-associated pneumonia prevention methods and the incidence of ventilator-associated pneumonia in intensive care units.

Study Overview

• Status: Unknown
• Conditions: The Incidence of Ventilator-associated Pneumonia and Rate of Compliance With Survey Criteria
• Intervention / Treatment: Other: ventilator-associated pneumonia-developed group followed by mechanical ventilation; Other: not ventilator-associated pneumonia-developed group followed by mechanical ventilation

Detailed Description

In the first stage of the study, Diskapi Yildirim Beyazit Education and Research Hospital Anesthesia Reanimation 1-2-3-4, compliance with ventilator-associated pneumonia prevention rules in neurology, neurosurgery, and internal medicine intensive care units will be investigated. The researcher will visit the intensive care units included in the study twice a day (10:00 and 14:00) by Dr. Gökhan Erdem for 1 week at the same time of day and monitor whether they work in accordance with VAP prevention rules.

VAP prevention methods: Head angle 30-45 degrees, peptic ulcer prophylaxis, thromboembolism prophylaxis, daily wake up test, use of chlorhexidine in oral care, bacterial filter use in ventilator circuit, daily spontaneous breathing trials, silver-coated endotracheal tube use, cuff pressure adequacy, hand hygiene , VAP nurse training, avoiding excessive distension of the stomach, equipment contamination, mechanical tooth cleaning, daily assessment for patient separation from mechanical ventilation, sterile aspiration technique, use of sterile gloves before aspiration, aspiration of subglottic secretions will be recorded.

In the second stage of the study, Diskapi Yildirim Beyazit Education and Research Hospital anesthesia reanimation 1-2-3-4, demographic characteristics of all hospitalized patients for neurological, neurosurgery, and internal medicine intensive care units, reason for hospitalization in intensive care unit, APACHE score, duration of mechanical ventilation, length of stay in ICU unit, blood transfusion, urinary infection, wound infection, presence of infection in at least one site, duration and type of surgery if operated, post-op prophylactic antibiotic use, history of CPR, history of difficult intubation, shape and duration of intubation, presence of tracheostomy , time from intubation to tracheostomy opening, residence time in ICU, change of filters in mechanical ventilator circuits, antibiotic use, low serum albumin value, sedative use, steroid use, feeding type, inotropic requirement, prokinetic agent use, number of bed personnel and nurses, reentubation history, transport history, glaskow coma score, frequency of endotracheal aspiration, peep need, smoking history, nasogastric use, chest tube, central venous catheter, presence of arterial catheter, history of dialysis, continuous infusion therapy, aerosol therapy, chronic diseases will be recorded. Patients under 18 years of age who had previously been diagnosed with pneumonia, lung expansion devices such as cpap, nasal peep, hypocpap were not applied via tracheostomy or endotracheal intubation, and patients due to high frequency ventilation or extracorporeal life support were excluded from VAP surveillance.

• Study Type: Observational
• Enrollment (Anticipated): 100

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients followed up on mechanical ventilation by tracheostomy or endotracheal intubation in ICUs aged 18 and over

Description

Inclusion Criteria:

• patients followed for more than 48 hours on a mechanical ventilator

Exclusion Criteria:

• previously diagnosed with pneumonia
• Patients under the age of 18
• Unless lung expansion devices such as cpap, nasal peep, hypo cpap are applied via tracheostomy or endotracheal intubation
• patients due to high frequency ventilation or extracorporeal life support

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
positive; ventilator-associated pneumonia-developed group followed by mechanical ventilation	Other: ventilator-associated pneumonia-developed group followed by mechanical ventilation; compliance with ventilator-associated pneumonia prevention methods and investigating the incidence of ventilator-associated pneumonia in intensive care units
negative; not ventilator-associated pneumonia-developed group followed by mechanical ventilation	Other: not ventilator-associated pneumonia-developed group followed by mechanical ventilation; compliance with ventilator-associated pneumonia prevention methods and investigating the incidence of ventilator-associated pneumonia in intensive care units

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Investigation of ventilator-associated pneumonia incidence in intensive care units	The development of ventilator-associated pneumonia leads to many negative conditions. Therefore, the incidence of ventilator-associated pneumonia is important in terms of decreasing hospital care costs, requiring longer mechanical ventilation, length of hospital stay, mortality and morbidity.	01.12.2019-01.03.2020

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Investigation of compliance with ventilator-associated pneumonia prevention methods in intensive care units	Compliance with ventilator-related pneumonia prevention rules will be investigated in the intensive care units of Diskapi Yildirim Beyazit Training and Research Hospital.	01.12.2019-01.03.2020

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Investigation of possible risk factors for ventilator-associated pneumonia	The parameters that may affect ventilator-associated pneumonia rates in patients who were supported by invasive mechanical ventilator in intensive care units of Diskapi Yildirim Beyazit Training and Research Hospital will be recorded.	01.12.2019-01.03.2020

Collaborators and Investigators

• Sponsor: Diskapi Teaching and Research Hospital

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): December 1, 2019
• Primary Completion (ANTICIPATED): March 1, 2020
• Study Completion (ANTICIPATED): April 1, 2020

Study Registration Dates

• First Submitted: November 20, 2019
• First Submitted That Met QC Criteria: November 21, 2019
• First Posted (ACTUAL): November 22, 2019

Study Record Updates

• Last Update Posted (ACTUAL): November 22, 2019
• Last Update Submitted That Met QC Criteria: November 21, 2019
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Lung Diseases; Disease Attributes; Cross Infection; Iatrogenic Disease; Healthcare-Associated Pneumonia; Pneumonia; Pneumonia, Ventilator-Associated
• Other Study ID Numbers: VAP incidence and compliance

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No