2.50
Hdl Handle:
http://hdl.handle.net/10755/157064
Category:
Abstract
Type:
Presentation
Title:
Pediatric Ventilator-Associated Pneumonia Registry (VAPoR): A Precise VAP Detection Tool.
Author(s):
Wincek, Jeni M.; Forbes, Michael; Boville, Brian; Lukasiewicz, Gloria; Johnson, Karen; Blanton, Rachel; Gupta, Sameer
Author Details:
Jeni M. Wincek, RN,MSN, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA, email: jeni.wincek@devoschildrens.org; Michael Forbes; Brian Boville; Gloria Lukasiewicz; Karen Johnson; Rachel Blanton; Sameer Gupta
Abstract:
POSTER PURPOSE: A prospective quality improvement study was conducted by the National Association of ChildrenÆs Hospitals and Related Institutions (NACHRI) Pediatric Intensive Care Unit (PICU) FOCUS Group to better define ventilator-associated pneumonia (VAP) in children. Through a national pediatric VAP registry, a stringent method for VAP surveillance and VAP detection was implemented by 16 PICUs. With consistency in VAP detection, this study has led to a better understanding of pediatric VAP. BACKGROUND/SIGNIFICANCE:VAP is one of the most common hospital-acquired infections in PICUs. The National Nosocomial Infection Surveillance report defined PICU VAP rates as 2.5/1000 ventilator days, affecting 3% to 10% of children receiving mechanical ventilation. VAP is associated with increased mortality, morbidity, and cost. A survey of 16 PICUs showed significant variability in VAP surveillance methods with many not performing any surveillance. This results in unreliable pediatric VAP data for use in comparative studies. METHOD: Sixteen PICUs collaborated to implement a stringent, prospective method of VAP detection. A Web-based pediatric VAP registry was constructed, and before data submission all study participants were trained in VAP surveillance and detection processes that strictly adhered to the Center for Disease Control and PreventionÆs 2008 PNU1 criterion. Sites conducted daily surveillance data for 6 consecutive months, uploading surveillance and detection data as well as other demographic and clinical data. Data from the Virtual PICU System (VPSLLC), a national PICU database, including case-specific severity of illness scoring and other clinical information, were analyzed to gain a better understanding of pediatric VAP. RESULTS: After 6 months, approximately 2000 ventilator patients have been enrolled in the registry. Interim analysis shows an overall VAP rate for participating institutions of 7.17 VAPs/1000 ventilator days. This rate differs greatly from the previously reported rates by the National Nosocomial Infection Surveillance (2.5/1000 ventilator days). There were no differences in mortality between children with and without VAP, and those children with VAP had significantly longer durations of mechanical ventilation (P=.004). Procedures such as endotracheal tube change (P=.009), flexible bronchoscopy (P<.001), and transfer from another institution (P=.02) were significantly associated with VAP. CONCLUSIONS: As a limited number of VAP cases are confirmed in any PICU, the multi-institutional approach to this study was critical to collecting sufficient data for a more accurate description of pediatric VAP. In an effort to help create more precise criteria for pediatric VAP detection, interim findings specific to surveillance and diagnostic criteria were presented to the Centers for Disease Control and Prevention. This study can serve as foundation for further studies aimed at testing the impact of specific VAP prevention.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titlePediatric Ventilator-Associated Pneumonia Registry (VAPoR): A Precise VAP Detection Tool.en_GB
dc.contributor.authorWincek, Jeni M.en_GB
dc.contributor.authorForbes, Michaelen_GB
dc.contributor.authorBoville, Brianen_GB
dc.contributor.authorLukasiewicz, Gloriaen_GB
dc.contributor.authorJohnson, Karenen_GB
dc.contributor.authorBlanton, Rachelen_GB
dc.contributor.authorGupta, Sameeren_GB
dc.author.detailsJeni M. Wincek, RN,MSN, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA, email: jeni.wincek@devoschildrens.org; Michael Forbes; Brian Boville; Gloria Lukasiewicz; Karen Johnson; Rachel Blanton; Sameer Guptaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157064-
dc.description.abstractPOSTER PURPOSE: A prospective quality improvement study was conducted by the National Association of Children&AElig;s Hospitals and Related Institutions (NACHRI) Pediatric Intensive Care Unit (PICU) FOCUS Group to better define ventilator-associated pneumonia (VAP) in children. Through a national pediatric VAP registry, a stringent method for VAP surveillance and VAP detection was implemented by 16 PICUs. With consistency in VAP detection, this study has led to a better understanding of pediatric VAP. BACKGROUND/SIGNIFICANCE:VAP is one of the most common hospital-acquired infections in PICUs. The National Nosocomial Infection Surveillance report defined PICU VAP rates as 2.5/1000 ventilator days, affecting 3% to 10% of children receiving mechanical ventilation. VAP is associated with increased mortality, morbidity, and cost. A survey of 16 PICUs showed significant variability in VAP surveillance methods with many not performing any surveillance. This results in unreliable pediatric VAP data for use in comparative studies. METHOD: Sixteen PICUs collaborated to implement a stringent, prospective method of VAP detection. A Web-based pediatric VAP registry was constructed, and before data submission all study participants were trained in VAP surveillance and detection processes that strictly adhered to the Center for Disease Control and Prevention&AElig;s 2008 PNU1 criterion. Sites conducted daily surveillance data for 6 consecutive months, uploading surveillance and detection data as well as other demographic and clinical data. Data from the Virtual PICU System (VPSLLC), a national PICU database, including case-specific severity of illness scoring and other clinical information, were analyzed to gain a better understanding of pediatric VAP. RESULTS: After 6 months, approximately 2000 ventilator patients have been enrolled in the registry. Interim analysis shows an overall VAP rate for participating institutions of 7.17 VAPs/1000 ventilator days. This rate differs greatly from the previously reported rates by the National Nosocomial Infection Surveillance (2.5/1000 ventilator days). There were no differences in mortality between children with and without VAP, and those children with VAP had significantly longer durations of mechanical ventilation (P=.004). Procedures such as endotracheal tube change (P=.009), flexible bronchoscopy (P<.001), and transfer from another institution (P=.02) were significantly associated with VAP. CONCLUSIONS: As a limited number of VAP cases are confirmed in any PICU, the multi-institutional approach to this study was critical to collecting sufficient data for a more accurate description of pediatric VAP. In an effort to help create more precise criteria for pediatric VAP detection, interim findings specific to surveillance and diagnostic criteria were presented to the Centers for Disease Control and Prevention. This study can serve as foundation for further studies aimed at testing the impact of specific VAP prevention.en_GB
dc.date.available2011-10-26T19:23:19Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:23:19Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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