Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review

Introduction: This review aimed at investigating the impact of bundle components on the prevention of ventilator-associated pneumonia (VAP) in adults and the elderly. Methodology: The databases consulted were PubMed, EBSCO, and Scielo. The terms Bundle and Pneumonia were searched in combination....

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Main Authors: Maria Dagmar Da Rocha Gaspar, Elaine Cristina Antunes Rinaldi, Rosiane Guetter Mello, Fábio André Dos Santos, Jessica Mendes Nadal, Luciane Patricia Andreane Cabral, Paulo Vitor Farago
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12202
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author Maria Dagmar Da Rocha Gaspar
Elaine Cristina Antunes Rinaldi
Rosiane Guetter Mello
Fábio André Dos Santos
Jessica Mendes Nadal
Luciane Patricia Andreane Cabral
Paulo Vitor Farago
author_facet Maria Dagmar Da Rocha Gaspar
Elaine Cristina Antunes Rinaldi
Rosiane Guetter Mello
Fábio André Dos Santos
Jessica Mendes Nadal
Luciane Patricia Andreane Cabral
Paulo Vitor Farago
author_sort Maria Dagmar Da Rocha Gaspar
collection DOAJ
description Introduction: This review aimed at investigating the impact of bundle components on the prevention of ventilator-associated pneumonia (VAP) in adults and the elderly. Methodology: The databases consulted were PubMed, EBSCO, and Scielo. The terms Bundle and Pneumonia were searched in combination. The original articles were selected in Spanish and English; published between January 2008 and December 2017. After eliminating the duplicate papers, an analysis of the titles and the abstracts was performed in order to select the assessed articles. A total of 18 articles were included in this review that were evaluated according to the following criteria: research reference, country of data collection, type of study, characteristics of the studied patients, analysis and intervention performed, bundle items investigated and their results, and research outcome. Results: Four bundle items were presented in all the investigated papers. 61% of those works were considered from seven to eight bundle items. Daily evaluation of sedation interruption and daily assessment for verifying extubation condition, head-of-bed elevation at 30 degrees, cuff pressure monitoring, coagulation prophylaxis, and oral hygiene were the most reported bundle items. One study described the increased mortality of patients under mechanical ventilation when omitted the bundle items of oral hygiene and stress ulcer prophylaxis. Head-of-bed elevation at 30 degrees was the item reported in 100% of the studied papers. Conclusions: Existing research demonstrated that VAP reduction occurred when bundle items were performed for adults and the elderly. Four works showed the relevance of team education as a central approach to the event reduction related to the ventilator.
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spelling doaj-art-404eb20f58e54ca2af35d109e74c8d8b2025-08-20T02:14:16ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-02-01170210.3855/jidc.12202Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic reviewMaria Dagmar Da Rocha Gaspar0Elaine Cristina Antunes Rinaldi1Rosiane Guetter Mello2Fábio André Dos Santos3Jessica Mendes Nadal4Luciane Patricia Andreane Cabral5Paulo Vitor Farago6Department of Nursing and Public Health, State University of Ponta Grossa, Ponta Grossa, Paraná, BrazilDepartment of Nursing and Public Health, State University of Ponta Grossa, Ponta Grossa, Paraná, BrazilLittle Prince Colleges, Curitiba, Paraná, BrazilDepartment of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, BrazilPostgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, BrazilDepartment of Nursing and Public Health, State University of Ponta Grossa, Ponta Grossa, Paraná, BrazilPostgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil Introduction: This review aimed at investigating the impact of bundle components on the prevention of ventilator-associated pneumonia (VAP) in adults and the elderly. Methodology: The databases consulted were PubMed, EBSCO, and Scielo. The terms Bundle and Pneumonia were searched in combination. The original articles were selected in Spanish and English; published between January 2008 and December 2017. After eliminating the duplicate papers, an analysis of the titles and the abstracts was performed in order to select the assessed articles. A total of 18 articles were included in this review that were evaluated according to the following criteria: research reference, country of data collection, type of study, characteristics of the studied patients, analysis and intervention performed, bundle items investigated and their results, and research outcome. Results: Four bundle items were presented in all the investigated papers. 61% of those works were considered from seven to eight bundle items. Daily evaluation of sedation interruption and daily assessment for verifying extubation condition, head-of-bed elevation at 30 degrees, cuff pressure monitoring, coagulation prophylaxis, and oral hygiene were the most reported bundle items. One study described the increased mortality of patients under mechanical ventilation when omitted the bundle items of oral hygiene and stress ulcer prophylaxis. Head-of-bed elevation at 30 degrees was the item reported in 100% of the studied papers. Conclusions: Existing research demonstrated that VAP reduction occurred when bundle items were performed for adults and the elderly. Four works showed the relevance of team education as a central approach to the event reduction related to the ventilator. https://jidc.org/index.php/journal/article/view/12202Elderly healthhead-of-bed elevationintensive care unitmechanical ventilationoral hygiene
spellingShingle Maria Dagmar Da Rocha Gaspar
Elaine Cristina Antunes Rinaldi
Rosiane Guetter Mello
Fábio André Dos Santos
Jessica Mendes Nadal
Luciane Patricia Andreane Cabral
Paulo Vitor Farago
Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
Journal of Infection in Developing Countries
Elderly health
head-of-bed elevation
intensive care unit
mechanical ventilation
oral hygiene
title Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
title_full Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
title_fullStr Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
title_full_unstemmed Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
title_short Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review
title_sort impact of evidence based bundles on ventilator associated pneumonia prevention a systematic review
topic Elderly health
head-of-bed elevation
intensive care unit
mechanical ventilation
oral hygiene
url https://jidc.org/index.php/journal/article/view/12202
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