Skip Navigation LinksHome > January 2009 - Volume 16 - Issue 1 > Safety in Critical Care and Pulmonary Medicine: Should Venti...
Clinical Pulmonary Medicine:
doi: 10.1097/CPM.0b013e3181940508
Critical Care/Respiratory Care

Safety in Critical Care and Pulmonary Medicine: Should Ventilator-Associated Pneumonia Be a Quality Indicator for Patient Safety?

Lisboa, Thiago MD*; Craven, Donald E. MD†‡; Rello, Jordi MD, PhD*

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Abstract

Prevention of nosocomial infections constitutes a strategy to improve patient safety and quality of care in intensive care unit (ICU). Infection prevention measures, specifically targeting ventilator-associated pneumonia (VAP), have been purposed as quality of care indicators for ICU patients. We discuss some of the recent evidence on the prevention of nosocomial infections with a particular emphasis on VAP. Moreover, there are several pitfalls in considering VAP rate as a quality indicator that include difficulties with sensitivity, specificity of VAP diagnosis, variability in surveillance methods, differences in patient case-mix between hospitals, and the risk of underreporting or manipulating VAP rates. Because of these limitations, we recommend the use of specific process measures to reduce VAP as for interinstitutional benchmarking.

© 2009 Lippincott Williams & Wilkins, Inc.

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