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Guidance issued on prevention of VAP
New guidance developed by a consortium of professional organizations offers strategies to prevent ventilator-associated pneumonia in acute care facilities for adult, pediatric and neonatal populations.
Published in Infection Control and Hospital Epidemiology, the guidance is featured in an update of the “Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Hospitals.” It is the result of a joint effort between the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission.
“Because the Compendium consists of guidance documents rather than guidelines, we have flexibility to include recommendations where the formal grading of the quality of evidence is relatively low, but where experts agree that the potential benefits outweigh potential risks and costs,” Michael Klompas, MD, MPH, associate professor in the department of population medicine at Harvard Medical School, said in a press release. “This is especially important for younger patient populations where evidence is sparse.”
The guidance includes prevention strategies and approaches to consider for hospitals with rates of ventilator-associated pneumonia (VAP) that are not improving, despite good basic practices. The guidance also includes attributes of improvement programs that have been already implemented successfully.
For adult patients, the strategies to prevent VAP include: avoiding intubation, minimizing sedation, assessing readiness to extubate daily, encouraging exercise and mobilization, using endotracheal tubes with subglottic secretion drainage for high-risk patients and elevating the head of the bed.
For pediatric and neonatal patients, the VAP prevention strategies include avoiding intubation, minimizing the duration of mechanical ventilation, providing regular oral care, and elevating the head of the bed (for pediatric patients only).
Disclosure: The authors report relationships with Advanced Circulatory Systems, Advanced Sterilization Products, Care Fusion, Covidien, Hamilton, Ikaria and Infection Control Today.