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Abstract PD-040: DETERMINING THE IMPACT OF IMPROVING ORAL HYGIENE ON VENTILATOR-ASSOCIATED PNEUMONIA RATE IN A PAEDIATRIC INTENSIVE CARE UNIT

Jennings, C.1; Morgan, D.1; Gopisetti, S.1; Ryan, C.1; Playfor, S.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 42
doi: 10.1097/01.pcc.0000537442.29558.da
Poster Discussion Abstracts
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1Royal Manchester Children’s Hospital, Paediatric Critical Care, Manchester, United Kingdom

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Aims & Objectives:

A service improvement initiative was implemented to improve oral hygiene within Paediatric Intensive Care, and its impact on our ventilator-associated pneumonia rate was determined.

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Methods

A retrospective audit at Royal Manchester Children’s Hospital was undertaken to determine a baseline rate of ventilator-associated pneumonia (VAP). Electronic records of all patients with a length of stay (LOS) greater than 7 days were reviewed to observe occurrence of any ventilator associated events (VAE), and further analysed to confirm data as VAP.

Sage Q4Care Petite was introduced for all patients in PICU who met the criteria, supported by a training/education package for staff.

Post-intervention, data was collected for 6 months to examine the prevalence of VAE/VAP and establish any impact.

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Results

Prior to intervention, 164 patients had a LOS>7 days, with a total number of ventilator-bed days = 1526, and 22 cases were confirmed as a VAP – a VAP rate of 14.4 per 1000 ventilator-bed days.

Within 8 weeks of introduction of the product, compliance in oral care increased from 10% to 80%.

Post intervention, 102 patients had a LOS>7day, with a total number of ventilator-bed days=978, and 4 cases were identified as a VAP - a rate of 4.1 per 1000 ventilator-bed days.

The intervention resulted in a statistically significant improvement in the rate of VAP; p<0.05 (Fisher exact test).

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Conclusions

This initiative has provided evidence that improving oral health has significantly reduced the incidence of VAP in our critical care. A VAP bundle is being developed to further investigate other factors which may have effect.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies