Implementation of a high impact intervention to prevent Ventilator Associated Pneumonia – A before and after study

Mrs Elyse Ladbrook1, Dr Stephane Bouchoucha1, Associate Professor Ana Hutchinson1

1Deakin University, Melbourne, VIC, Australia



Ventilator-associated pneumonia is a common avoidable healthcare associated infection that can develop in ventilated critical care patients. Ventilator-associated pneumonia has a detrimental impact on patient recovery and can increase the burden of care . High impact interventions, such as care bundles, are strategies that can mitigate the risk for ventilator-associated pneumonia and achieve positive patient health outcomes. The aims of this study were to determine the change in uptake of evidence-based nursing care, after implementation of a ventilator care bundle within a tertiary level intensive care unit.


A before and after observational design was used to evaluate the uptake of a ventilator care bundle. The care budle comprosed five evidence based elements: (1) adherence to infection prevention and control measures, (2) head of the bed elevation > 30 degrees, (3) mouth care, (4) maintenance of artificial airway and (5) titration of sedation.


Data from 80 shifts were analysed (39 before and 41 after). This represented care delivered by 32 nurses. Overall, the formal promotion and implementation of the bundle saw an improvement in adherence to all elements of the bundle, although an increase in head of bed elevation (> 30 degrees) was the only element that reached statistical significant (p = .01).


Adherence to infection prevention and control measures is vital to ensure the safety of clinicians, patients and their families. Strategies to overcome barriers to adherence are essential and should be developed and evaluated to meet the demands and needs of the healthcare organisation.


Elyse Ladbrook is a critical care nurse with an interest infection prevention and control in the Intensive Care Context. Elyse undertook her Masters evaluating the introduction of a ventilator-associated pneumonia prevention bundle in a Tertiary hospital intensive care unit. She is currently working as a Clinical Development Nurse at Calvary Public Hospital Bruce.

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