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Clinical and demographic characteristics of adult ventilator-associated pneumonia patients at a tertiary care hospital system

Edwards, Clare (2015) Clinical and demographic characteristics of adult ventilator-associated pneumonia patients at a tertiary care hospital system. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Background: When a mechanical ventilator is used, the endotracheal tube can act as a track for pathogens to follow into the patient’s lungs where pneumonia can develop. This project evaluates reported Ventilator-Associated Pneumonia (VAP) events at an academic tertiary care hospital (TCH) system.
Objectives: The objectives of this study are to: 1.) Identify epidemiological data related to VAP, 2.) Identify the prevalence of possible (ps) and probable (pr) VAP, and 3.) Compare similar hospital groups for factors influencing cases and outcomes.
Methods: This project utilized data from the National Healthcare Safety Network (NHSN) and the TCH medical record system between January 1, 2013 and August 31, 2014. Only adult VAP patients were included in the study. Demographic and clinical data were analyzed using SAS 9.3 software.
Results: White men between 50-70 years of age were the majority of persons to develop VAP while at the TCH system. Most patients were diagnosed with psVAP, but had no major differences from prVAP patients. This review shows that daily PEEP values are not being monitored by hospitals. All hospitals had both a high mortality and a high readmission rate. Suburban facilities accounted for 76% of psVAP cases, 41% of mortalities, and 60% of all readmissions.
Conclusions: Infection Prevention teams, especially in suburban hospitals, must identify the cause of high VAP complications and adverse outcomes within the dominant population. It is important that practice and procedure match to ensure patient safety.
Public Health Significance: Every community trusts healthcare facilities to provide safe and effective treatment. However, Healthcare-Acquired Infections (HAI) deter individuals from optimal health, and may lead to increased antibiotic use and resistance. Mechanical ventilation, while essential, breaches protective barriers and increases the risk for potential HAI. Infection Preventionists aid patients on their journey to better health by working to eliminate HAIs. This study is the first step to aid Infection Prevention teams throughout the healthcare system in encouraging continued surveillance, evaluation of practice and procedure, and decreasing hospital-acquired infections overall to reinforce community safety.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Edwards, Clarecme33@pitt.eduCME33
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSilvestre, Anthony J.tonys@pitt.eduTONYS
Committee MemberGlynn, Nancyglynnn@edc.pitt.eduEPIDNWG
Committee MemberGaldys, Alisonbonowal@upmc.edu
Committee MemberFerrelli, JulietFerrellijg@upmc.edu
Date: 28 January 2015
Date Type: Publication
Defense Date: 20 November 2014
Approval Date: 28 January 2015
Submission Date: 10 December 2014
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 48
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: VAP, Possible VAP, Probable VAP, pneumonia, Ventilator-Associated Pneumonia, Ventilator Associated Pneumonia
Date Deposited: 28 Jan 2015 14:57
Last Modified: 15 Nov 2016 14:26
URI: http://d-scholarship.pitt.edu/id/eprint/23839

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