Data from: Prevention of ventilator-associated pneumonia in intensive care units: an international online survey

Background: On average 7% of patients admitted to intensive-care units (ICUs) suffer from a potentially preventable ventilator-associated pneumonia (VAP). Our objective was to survey attitudes and practices of ICUs doctors in the field of VAP prevention. Methods: A questionnaire was made available online in 6 languages from April, 1st to September 1st, 2012 and disseminated through international and national ICU societies. We investigated reported practices as regards (1) established clinical guidelines for VAP prevention, and (2) measurement of process and outcomes, under the assumption “if you cannot measure it, you cannot improve it”; as well as attitudes towards the implementation of a measurement system. Weighted estimations for Europe were computed based on countries for which at least 10 completed replies were available, using total country population as a weight. Data from other countries were pooled together. Detailed country-specific results are presented as an online supplement. Results: A total of 1730 replies were received from 77 countries; 1281 from 16 countries were used to compute weighted European estimates, as follows: care for intubated patients, combined with a measure of compliance to this guideline at least once a year, was reported by 57% of the respondents (95% CI: 54-60) for hand hygiene, 28% (95% CI: 24-33) for systematic daily interruption of sedation and weaning protocol, and 27% (95%: 23-30) for oral care with chlorhexidine. Only 20% (95% CI: 17-22) were able to provide an estimation of outcome data (VAP rate) in their ICU, still 93% (95% CI: 91-94) agreed that “Monitoring of VAP-related measures stimulates quality improvement”. Results for 449 respondents from 61 countries not included in the European estimates are broadly comparable. Conclusions: This study shows a low compliance with VAP prevention practices, as reported by ICU doctors in Europe and elsewhere, and identifies priorities for improvement背景：入住重症监护病房（intensive-care units, ICUs）的患者中，平均有7%会罹患可预防性呼吸机相关性肺炎（ventilator-associated pneumonia, VAP）。本研究旨在调查重症监护医师在VAP预防领域的认知与实践现状。 方法：本研究于2012年4月1日至9月1日期间，以6种语言在线发布问卷，并通过国际及各国重症监护学会进行传播。本研究围绕两项核心内容调查受访者报告的实践情况：一是VAP预防的既定临床指南执行情况，二是流程与结局指标的评估——基于“若无法衡量，便无法改善”的经典假设；同时调研受访者对搭建VAP预防效果评估系统的态度。本研究以至少收集到10份有效回复的国家为样本，以对应国家的总人数作为权重，计算欧洲区域的加权估算值；其余国家的数据则合并汇总。各国详细结果以在线补充材料形式呈现。 结果：本研究共收到来自77个国家的1730份有效回复；其中来自16个国家的1281份回复用于计算欧洲区域的加权估算值，具体如下：针对气管插管患者的照护，且每年至少开展1次该指南依从性评估的受访者占比为：手卫生57%（95%置信区间：54~60）、每日系统性镇静中断与脱机方案28%（95%置信区间：24~33）、使用氯己定进行口腔护理27%（95%置信区间：23~30）。仅20%（95%置信区间：17~22）的受访者能够提供所在重症监护病房的VAP结局指标（VAP发生率）估算数据，但仍有93%（95%置信区间：91~94）的受访者认同“监测VAP相关措施可推动医疗质量改进”。来自未纳入欧洲区域估算的61个国家的449份回复结果，整体与上述数据基本一致。 结论：本研究显示，欧洲及全球其他地区的重症监护医师报告的VAP预防实践依从性偏低，并明确了亟待改进的重点方向。