217. Epidemiological and Economic Impact on the Prevention and Control of Ventilator-Associated Pneumonia in Intermediate Care Unit: A Model of Effective Analysis
Session: Poster Abstract Session: Criticare, HAIs: Pneumonia and Chlorhexidine
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Poster final LFR.pdf (1.0 MB)
  • Background: Between the months of August and September 2011, in the Intermediate Care Unit was an outbreak of Ventilator-Associated Pneumonia (VAP), for this a project was implemented focused to prevent and control pneumonia. The objective was to evaluate the impact epidemiologic and economic obtained with the implementation project in reducing the incidence rate of VAP and effective costs in the treatment of care.

    Methods: A cross sectional study was developed in the Intermediate Care Unit for respiratory patients comparing before and after. The study was divided into a prospective analysis (post-intervention from October 2011 to September 2012) and a retrospective pre-intervention, (from January to September 2011). The project was implemented and compared the rate of VAP and the costs in both phases. Consists in 3 components: architectural and structural modifications, staff and education of area y process reengineering. The information was obtained through clinical records from 33 patients, who met the criteria for VAP. To estimate the direct costs of treatment following data were obtained: hospital stay, laboratory test, imaging exams, and used antibiotics (doses and time). Their costs were estimated from the values established for the administrative direction of the hospital.

    Results: 22 cases were identified in the first period; the initial incidence rate was 26.93/1000 ventilator days, the average length of stay before infection was 9.8 days, average length of stay with VAP was 16.72 days; 5 deaths were attributed to infection with a fatality rate of 22.73, the average cost of treating a case of HAI was US$13,998, the total cost of these 22 cases was of US$578,598. In the second period identified 11 cases, the incidence rate was 3.18/1000 ventilator days, the average length of stay before infection was 11.45 days, average length of stay with VAP was 11.54; 2 death were attributed to infection with a fatality rate of 18.2, the average cost of treating a case of HAI was US$12,629.1, the total cost of these 11 cases was of US$170,040. The total cost of implementation project was US$20,318, the difference in cost between a period and the other was US$388,240, which represents a saving of 70%.

    Conclusion: The implementation of the project was associated with a significant decrease in the incidence rate of VAP and in the costs of treatment.

    Lillyana Flores, MD1, Ricardo Valdés, MD2, Oscar Sosa, MD2, Patricia Rodríguez, MD1, Araceli Contreras1, Rafael Figueroa, MD1 and Rafael Valdez, MD3, (1)Hospital Epidemiology, Hospital General "Dr. Manuel Gea González", Mexico City, Mexico, (2)Hospital Epidemiology, Hospital General, Mexico City, Mexico, (3)Infectology, Hospital Manuel Gea Gonzalez, Mexico City, Mexico

    Disclosures:

    L. Flores, None

    R. Valdés, None

    O. Sosa, None

    P. Rodríguez, None

    A. Contreras, None

    R. Figueroa, None

    R. Valdez, None

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