Audit on compliance of ventilator associated pneumonia care bundle in Intensive Care units in National Hospital Sri Lanka

Introduction: Nosocomial infections are a major health concern worldwide, ventilator-associated pneumonia (VAP) is the most common healthcare associated infection in adult critical care units.？ VAP is associated with increased length of stay in intensive care units (ICU), days in ventilator, and mortality by about 30%. Because of the seriousness of the needs, VAP care bundle was introduced in 2007.

？

Objective -To assess the compliance to the ventilator care bundle in critical care units in the National Hospital Sri Lanka (NHSL).

？

Method – A descriptive cross-sectional study was conducted over a period of one month in ICUs in the NHSL.？ Evidence of compliance of the ventilator care bundle components were assessed using a standard data collection form. The assessed components were elevation of head of bed, adequate endotracheal tube cuff pressure, oral care with chlorhexidine, sedation vacation, peptic ulcer prophylaxis, and adherence to sub glottis suction. Ethical clearance was obtained from the Ethical review committee of NHSL.

？

Results – Adherence to all six components of the bundle was low as 28%. Out of different ICUs at NHSL only three of them adhered to the total bundle care, namely medical, surgical and neuro trauma ICU. Head of bed elevation was adhered universally, and minimum adherence was shown to subglottic suction which was 39.08%.

？

Conclusion - Total VAP care bundle compliance was low (28%) in this study sample.？ Even though there is improvement of ventilator bundle care from 2011, overall practice was unsatisfactory and particular attention should be paid in terms of adherence to subglottic suction, oral care with chlorhexidine and sedation vacation.