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Prevention of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

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Abstract

Hospital-acquired pneumonia (HAP) is the most frequent hospital infection after urinary tract infection, while it is at the first place in ICU. Actually, a HAP in ventilated patients is a ventilator-associated pneumonia. HAP and VAP determine increases in hospital lengths of stay and costs than patients without HAP or VAP. HAP and VAP are classified as early onset (≤4 days) and late onset (>4 days). The mortality rates of early- and late-onset HAP or VAP are comparable. VAP is the main issue in ICU. Currently there is no gold standard for VAP diagnosis. The Centers for Disease Control and Prevention recently drafted some new surveillance definitions, introducing a tiered classification of ventilator-associated events for adult patients. Currently, the VAP preventive interventions are focused on three areas: reducing the time at risk, preventing endotracheal tube colonization, and minimizing contaminated modulation of colonization. Nurses play a fundamental role in the management of lots of these interventions. VAP bundle of care can be a useful tool set for prevention. However, there is a potential conflict coming from the absence of evidence of effectiveness about some bundle intervention and the need to implement it emerging from the common sense, as the case of 30° HOB elevation. Effective prevention strategies for VAP and HAI include professional, organizational, financial, and regulatory interventions.

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  1. Emergency & Trauma ICU, University Hospital Careggi, Florence, Italy

    Stefano Bambi R.N., B.S., M.A.S., O.N.N.-C.G.

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Bambi, S. (2018). Prevention of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia. In: Nursing in Critical Care Setting. Springer, Cham. https://doi.org/10.1007/978-3-319-50559-6_10

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