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JCOM Abstract

J Clin Outcomes Manage 
2013 Jun;20(6):256-262
Ventilator-associated pneumonia and pediatric post-acute care
O'Brien JE, Iovanna D, Dumas HM, Burke S, Maher A, Ladenheim B, Mast J, Pelegano J

Abstract Objective: To describe the definition, incidence, diagnosis, etiology, and treatment and prevention practices for ventilator-associated pneumonia (VAP) in 4 pediatric post-acute care hospitals. Methods: Retrospective medical record review for the 1-year period May 2009 through April 2010 of infants and children ages 4 months to 18 years requiring tracheostomy with assisted ventilation admitted to pediatric post-acute care hospitals. A data collection tool was developed to record responses to 30 questions regarding VAP definition, incidence, diagnosis, etiology, and treatment and prevention at each facility. Date were combined for descriptive data analysis. Results: Most facilities used the CDC definition of VAP. 28 cases of VAP were documented for 21,118 ventilator-days across facilities, accounting for a mean VAP rate of 1.33 over a 1-year period. Diagnostic practices were consistent while prevention practices varied. Antibiotic use was the only reported treatment but differed by type, route of administration, and days of use. Conclusions: Across pediatric post-acute care facilities, diagnostic procedures and method of treating VAP are consistent. While the incidence of VAP appears low, inconsistency exists in defining, treating, and preventing VAP. Greater use of prevention and treatment bundles should be considered.

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