Title

Use Of Project Impact® To Identify Factors Related To Ventilator-Associated Pneumonia

Abstract

Introduction: Development of ventilator-associated pneumonia (VAP) increases morbidity and mortality. Using available databases, identification of factors associated with VAP can assist clinicians in development and implementation of prevention strategies. Method: A retrospective, descriptive design was used for this study. Power analysis for correlations with an α of .05, determined that the statistical power for a sample of 120 was .93. A convenience sample of 120 mechanically ventilated patients admitted to the critical care units of a level I trauma center from 5/1/98-7/31/98 was used. Data were obtained from the Project IMPACT®, infection control and financial databases. Variables included demographic data, VAP organism, medications, comorbidities, complications, days of therapies, length of stay and cost/case. Results: The average patient was a 49 year old male. The sample was 48% trauma patients. The incidence of VAP was 16.7% (n= 20). Factors significantly associated with VAP included intubation days (r= .275, p= .005), ventilation days (r= .255, p = .005) feeding tube days (r= .295, p = .001), trauma (φ= .239, p= .009), atelectasis (φ= -.186, p= .042) and histamine-2 (H 2) receptor antagonists (φ= -.253, p= .006). Variables that increased the odds ratio for VAP included tube feeding, H2 receptor antagonists, and atelectasis. Tracheotomy decreased the odds ratio for VAP, but early (day 1-7) tracheotomy did not decrease the incidence of VAP (χ2= .256, p= .613). Patients who developed VAP had a 16-day increase in length of stay (t= -2.68, p = .008) and a $29,369 increase in cost/ case (t= -3.649, p= .000) compared to patients without VAP. Conclusion: Using Project IMPACT and other databases to analyze risk factors for VAP, the findings support previous studies and provide a baseline for discussions regarding potential practice changes in this setting. This study is the first step towards clinical performance improvement and research activities aimed at reducing the rate of VAP in our patients.

Publication Date

1-1-1999

Publication Title

Critical Care Medicine

Volume

27

Issue

12 SUPPL.

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1097/00003246-199912001-00314

Socpus ID

33750677289 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/33750677289

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