Multidisciplinary rounds (MDRs) have been instituted for patient care since June 2005. Before June 2005, all care was provided by individual practitioners. MDRs include the surgical intensivist, surgical resident, patient's nurse, case manager, pharmacist, chaplain, nutritionist, and respiratory therapist. Our study examined the effect of MDRs on ventilator-associated pneumonia in trauma patients in open intensive care units (ICUs). Group 1 included patients from June 2003 to May 2005 before the implementation of MDRs, and Group 2 included patients after the institution of MDRs from June 2005 to May 2007. In Group 1, there were 83 ventilator-associated pneumonias (VAPs) during 2414 ventilator days. In Group 2, there were 49 VAPs during 2094 ventilator days. The ratio of VAPs per thousand ventilator days decreased from 34.4 to 23.4 between the two groups (P = 0.04). When comparing trauma patients in our open ICU with similar mean Injury Severity Score and mean Abbreviated Injury Score for chest and for head and neck, implementing MDRs significantly decreased our incidence of VAP.
CarrB.G., KayeA.J., WiebeD.J.Emergency department length of stay: a major risk factor for pneumonia in intubated blunt trauma patients.J Trauma2007; 63: 9–12.
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KostadimaE., KaditisA.G., AlexopoulosElEarly gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients.Eur Respir J2005; 26: 106–11.
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JainM., MillerL., BeltD.Decline in ICU adverse events, nosocomial infection, and cost through a quality improvement initiative focusing on teamwork and culture change.Qual Saf Health Care2006; 15: 235–9.
