Ventilator-associated pneumonia prevention
Healthcare associated infections are a major cause of poor outcomes for patients. Ventilator associated-pneumonia, a subset of hospital acquired pneumonia, results in increased patient morbidity and mortality, prolonged length of stay and increased healthcare costs. Up to one quarter of patients requiring mechanical ventilation develop ventilator associated pneumonia.
Ventilator-associated pneumonia can be caused by the migration of microorganisms from colonised endotracheal and/or tracheostomy tubes, direct inoculation via bronchoscopy or other respiratory procedures or by aspiration. Affected patients may have prior underlying lung disease or immune suppression.
Minimising the risk of ventilator associated pneumonia
Intubation and tracheostomy tube insertion should only be undertaken by persons trained and competent in the technique.
Key recommendations are:
- ensure mechanical ventilation is absolutely necessary for the patient
- keep the duration of mechanical ventilation to the minimum possible - assess for sedation, weaning and extubation daily
- intubation and tracheostomy tube insertion should only be undertaken by persons trained and competent in the technique
- perform hand hygiene and wear appropriate personal protective equipment (PPE) before endotracheal or tracheostomy tube insertion or manipulation
- use oral rather than nasal endotracheal intubation, where possible
- use new ventilator circuit tubing for each patient or if it becomes soiled
- elevate the head of the bed, preferably to 45°, if possible
- consider the regular use of oral antiseptics
- document, in the patient’s records all procedures involving the endotracheal or tracheostomy tube.
For further information on the management of indwelling devices, contact SA Health's Infection Control Service on (08) 7425 7161.