Effect of intensive education and training of nurses on ventilator-associated pneumonia and central line-associated bloodstream infection incidence in intensive care unit at a tertiary care center in North India

Brief Communication IntroductIonCentral line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) are two major causes of secondary sepsis in critically ill patients responsible for worsening of clinical condition of patients despite initial response to primary disease process leading to Intensive Care Unit (ICU) admission.[1] The secondary sepsis in an already critically ill patient with multidrug-resistant flora of ICU leads to significant morbidity and even mortality.The cost of treatment increases exponentially due to the requirement of higher antibiotics and support system required in view of multiorgan dysfunction which sets in.[1] The old dictum of "prevention is better than cure" is probably true in ICU setting more than anywhere else.As nursing staffs are the backbone of any ICU and come in patient contact more than anyone else, their education and knowledge of practices to prevent secondary sepsis is of utmost importance.[2] The aim of our study was to establish baseline VAP and CLABSI incidence, to intervene by education, training, and feedback from nurses, and to analyze its impact on the incidence of VAP and CLABSI in postintervention phase. PatIents and MethodsAfter approval from the Institute Ethics committee (NK/2466/ Study/2816), the study was done in ICU of our institute.Our ICU is a 12-bedded adult ICU which admits mainly medical patients along with few surgical and obstetric patients.The data of all adult patients admitted in ICU with an ICU stay Objective: The aim was to analyze the impact of education and training of nurses on the incidence of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI).Patients and Methods: A prospective observational study at a tertiary care hospital included adult patients with Intensive Care Unit stay >48 h.The study was done in three phases: in Phase 1, baseline VAP and CLABSI incidence was calculated; in Phase 2, education and training of nurses; and in Phase 3, data were recollected for the incidence of VAP and CLABSI.Results: The baseline incidence of VAP in Phase 1 was 28.86/1000 ventilator days and that of CLABSI was 7.89/1000 central-line days.In Phase 3, the incidence of VAP increased to 35.06 and that of CLABSI decreased significantly, 1.73.Conclusion: Intensive education and training sessions with feedback from nurses over a period of 6 months led to significant reduction in the incidence of CLABSI; however, the incidence of VAP increased.