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Strategies to Enhance Adoption of Ventilator-Associated Pneumonia Prevention Interventions: A Systematic Literature Review

Published online by Cambridge University Press:  10 May 2016

Jente M. Goutier ,
Christine G. Holzmueller ,
Kelsey C. Edwards ,
Michael Klompas ,
Kathleen Speck  and
Sean M. Berenholtz
Jente M. Goutier
Affiliation:
Johns Hopkins Armstrong Institute for Patient Safety and Quality, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Christine G. Holzmueller
Affiliation:
Johns Hopkins Armstrong Institute for Patient Safety and Quality, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Kelsey C. Edwards
Affiliation:
Johns Hopkins Armstrong Institute for Patient Safety and Quality, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Michael Klompas
Affiliation:
Department of Medicine, Brigham and Women’s Hospital, and Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Kathleen Speck
Affiliation:
Johns Hopkins Armstrong Institute for Patient Safety and Quality, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Sean M. Berenholtz*
Affiliation:
Johns Hopkins Armstrong Institute for Patient Safety and Quality, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland Department of Surgery, School of Medicine, and Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
*
Armstrong Institute for Patent Safety and Quality, Johns Hopkins University, 750 East Pratt Street, 15th Floor, Baltimore, MD 21202 ([email protected]).
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Extract

Background

Ventilator-associated pneumonia (VAP) is among the most lethal of all healthcare-associated infections. Guidelines summarize interventions to prevent VAP, but translating recommendations into practice is an art unto itself.

Objective

Summarize strategies to enhance adoption of VAP prevention interventions.

Methods

We conducted a systematic literature review of articles in the MEDLINE database published between 2002 and 2012. We selected articles on the basis of specific inclusion criteria. We used structured forms to abstract implementation strategies and inserted them into the “engage, educate, execute, and evaluate” framework.

Results

Twenty-seven articles met our inclusion criteria. Engagement strategies included multidisciplinary teamwork, involvement of local champions, and networking among peers. Educational strategies included training sessions and developing succinct summaries of the evidence. Execution strategies included standardization of care processes and building redundancies into routine care. Evaluation strategies included measuring performance and providing feedback to staff.

Conclusion

We summarized and organized practical implementation strategies in a framework to enhance adoption of recommended evidence-based practices. We believe this work fills an important void in most clinical practice guidelines, and broad use of these strategies may expedite VAP reduction efforts.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 8 , August 2014 , pp. 998 - 1005
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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