A systematic approach for developing a ventilator-associated pneumonia prevention bundle - 28/05/16
, Nishi Rawat, MD a, b, c, Noah C. Weiner, BS a, b, Haddis G. Tujuba, BS a, b, Donna Farley, MPH, PhD a, Sean Berenholtz, MHS, MD a, b, dHighlights |
• | A new ventilator-associated pneumonia prevention bundle using a systematic approach to elicit clinician perceptions on potential interventions for ventilator-associated pneumonia was developed. |
• | There were 65 potential interventions identified through an extensive literature review. |
• | A 2-step Delphi method was implemented to gain consensus on the final list of interventions. |
• | There were 155 clinicians with expertise and interest in ventilator-associated pneumonia treatment and prevention who participated in the process of consensus development. |
• | There were 5 process and 14 structural or policy-driven interventions identified. |
Abstract |
Background |
Ventilator-associated pneumonia (VAP) is among the most common type of health care–associated infection in the intensive care unit and is associated with significant morbidity and mortality. Existing VAP prevention intervention bundles vary widely on the interventions included and in the approaches used to develop these bundles. The objective of this study was to develop a new VAP prevention bundle using a systematic approach that elicits clinician perceptions on which interventions are most important and feasible to implement.
Methods |
We identified potential interventions to include through a review of current guidelines and literature. We implemented a 2-step modified Delphi method to gain consensus on the final list of interventions. An interdisciplinary group of clinical experts participated in the Delphi process, which was guided by a technical expert panel.
Results |
We identified 65 possible interventions. Through the Delphi method, we narrowed that list to 19 interventions that included 5 process and 14 structural measures.
Conclusions |
We described a structured approach for developing a new VAP prevention bundle. Obtaining clinician input on what interventions to include increases the likelihood that providers will adhere to the bundle.
Le texte complet de cet article est disponible en PDF.Key Words : Ventilator-associated pneumonia, quality improvement, prevention, bundle
Plan
| Author Contributions: Ms. Speck carried out the literature and guideline review, coordinated the modified Delphi method, and helped draft the manuscript. Dr Rawat interpreted the results of the modified Delphi method and helped draft the manuscript. Mr. Weiner and Mr. Tujuba carried out the literature and guideline review, implemented the modified Delphi method, and carried out data collection. Dr Farley participated in the design of the study and analysis and interpretation of its results. Dr Berenholtz conceived the study, participated in its design, participated in interpretation of results, and helped draft the manuscript. All authors read and approved the final manuscript. |
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| Funding/Support: This work has been funded by the National Institutes of Health (grant no. R01HL105903). |
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| Conflicts of Interest: Dr Berenholtz receives support from the National Institutes of Health and Agency for Healthcare Research and Quality for grants and contracts focused on improving patient safety and quality, including ventilator-associated pneumonia prevention, and receives honoraria and travel expenses from various hospitals and hospital associations for consulting and speaking on topics related to improving patient safety and quality. The other authors have nothing to disclose. |
Vol 44 - N° 6
P. 652-656 - juin 2016 Retour au numéro
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