Ventilator-Associated Pneumonia (VAP) is the most prevalent healthcare-associated infections in Intensive Care Units (ICU). In decreasing its incidence, a VAP prevention bundle as one of infection control methods had been applied to the ventilated patients. This study aimed to determine the correlation between the use of the VAP prevention bundle and the incidence rate of VAP in the ICU at a regional general hospital. A cross-sectional study was done using surveillance data of the VAP prevention bundle implementation checklist from the infection control committee. The samples were chosen using a stratified random sampling method. They were selected from two ICU wards according to the inclusion and exclusion criteria from January to June 2019 (n: 189). Furthermore, every seven bundles and the incidence rate of VAP were scored and observed. The result showed that there were ten incidences of VAP with a mean of 3.7‰. The highest rate was found in May as 9.8‰ while the standard was less than 5.8‰. Descriptive results showed that 6 of 7 bundles were the highest total scores in 34.9% samples with oral hygiene as a bundle item at most frequently listed in 98.4% patients. Logistic regression also pointed out a significant correlation (p<0.05) between the use of the VAP prevention bundle and the incidence rate of VAP. Therefore, there was a significant correlation between the use of VAP prevention bundles and the incidence rate of VAP for ventilated patients in the ICU room. Thus, each VAP prevention bundle must be carried out entirely to affect the incidence rate of VAP.

• AllonAmitai. What Are the Adverse Effects of Mechanical Ventilation? 2018 (cited 2019 August 03). Available at: https://www.medscape.com/answers/810126-45470/what-are-the-adverse-effects-of-mechanical-ventilation
• Al-Tawfiq, J. A., & Abed, M. S. (2010). Decreasing ventilator-associated pneumonia in adult intensive care units using the Institute for Healthcare Improvement bundle. American journal of infection control, 38(7), 552-556.
• Amitai,A. Ventilator Management. 2013 (cited 2019 July 5). Available from: http://www.medscape.com/article/810126.
• Asoodeh, S., & Motlagh, A. T. (2015). Investigating the Density Ratios of Geological Structure through Fractal Geometry Case Stady:(Dehno Region in Farss of Iran). International Journal of Geography and Geology, 4(2), 37-46
• Benítez, L., & Ricart, M. (2005). Pathogenesis and environmental factors in ventilator-associated pneumonia. Enfermedades infecciosas y microbiologia clinica, 23, 10-17.
• Chen, J. K.-H., Chen, T.-H., Liu, H.-E., et al. (2014) Bundle Care for Preventing Ventilator-associated Pneumonia at a Medical Center: A Preliminary Report. J ExpClin Med 2014;6(5):157-160.
• Chung, T. Y., Huang, Y. C., Lin, C. S., Liu, S. L., Ge, M. C., & Liu, T. P. (2015). Investigation of a cluster of Bulkholderia cepacia complex infection in a pediatric intensive care unit. Journal of Microbiology, Immunology and Infection, 48(2), S88-S89.
• Depuydt, P., Myny, D., & Blot, S. (2006). Nosocomial pneumonia: aetiology, diagnosis and treatment. Current opinion in pulmonary medicine, 12(3), 192-197.
• Dezfulian, C., Shojania, K., Collard, H. R., Kim, H. M., Matthay, M. A., & Saint, S. (2005). Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. The American journal of medicine, 118(1), 11-18.
• Guide, H. T. (2012). Prevent ventilator-associated pneumonia. Cambridge, MA: Institute for Healthcare Improvement.
• Guillamet, C. V., & Kollef, M. H. (2018). Is zero ventilator-associated pneumonia achievable?: practical approaches to ventilator-associated pneumonia prevention. Clinics in Chest Medicine, 39(4), 809-822.
• Heck, K. (2012). Decreasing ventilator-associated pneumonia in the intensive care unit: a sustainable comprehensive quality improvement program. American journal of infection control, 40(9), 877-879.
• How to Prevent Ventilator-Associated Pneumonia (VAP). 2013 (cited 2019 August 03). Available at: https://www.americansentinel.edu/blog/2013/05/27/preventing-ventilator-associated-pneumonia-vap/
• Ibrahim, E. H., Tracy, L., Hill, C., Fraser, V. J., & Kollef, M. H. (2001). The occurrence of ventilator-associated pneumonia in a community hospital: risk factors and clinical outcomes. Chest, 120(2), 555-561.
• Intensive care. (cited 2019 August 03). Available at: https://www.nhs.uk/conditions/intensive-care/
• Kalil, A. C., Metersky, M. L., Klompas, M., Muscedere, J., Sweeney, D. A., Palmer, L. B., ... & El Solh, A. A. (2016). Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical Infectious Diseases, 63(5), e61-e111.
• Lerma, F. Á., García, M. S., Lorente, L., Gordo, F., Añón, J. M., Álvarez, J., ... & Jam, R. (2014). Guidelines for the prevention of ventilator-associated pneumonia and their implementation. The Spanish “Zero-VAP” bundle. Medicina intensiva, 38(4), 226-236.
• Mohamed, K. A. E. (2014). Compliance with VAP bundle implementation and its effectiveness on surgical and medical sub-population in adult ICU. Egyptian Journal of Chest Diseases and Tuberculosis, 63(1), 9-14.
• Morpeth, S. C., Ramadhani, H. O., & Crump, J. A. (2009). Invasive non-typhi Salmonella disease in Africa. Clinical Infectious Diseases, 49(4), 606-611.
• Nseir, S., Zerimech, F., Fournier, C., Lubret, R., Ramon, P., Durocher, A., & Balduyck, M. (2011). Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. American journal of respiratory and critical care medicine, 184(9), 1041-1047.
• Ozlem, A., Yasemin, E., Cigdem K., et al. (2017). Assessment of the Effectiveness of a Ventilator-associated Pneumonia Prevention Bundle that Contains Endotracheal Tube with Subglottic Drainage and Cuff Pressure Monitorization. The Brazilian Journal of Infectious Diseases. 2 1(3):276–281
• Rello, J., Afonso, E., Lisboa, T., Ricart, M., Balsera, B., Rovira, A., ... & FADO Project Investigators. (2013). A care bundle approach for prevention of ventilator-associated pneumonia. Clinical Microbiology and Infection, 19(4), 363-369.
• Reper, P., Dicker, D., Damas, P., Huyghens, L., & Haelterman, M. (2017). Improving the quality of the intensive care follow-up of ventilated patients during a national registration program. Public health, 148, 159-166.
• SARI Working Group. (2011). Guidelines for the prevention of ventilator-associated pneumonia in adults in Ireland. HSE Health Protection Surveillance Centre (HPSC).
• Speck, K., Rawat, N., Weiner, N. C., Tujuba, H. G., Farley, D., & Berenholtz, S. (2016). A systematic approach for developing a ventilator-associated pneumonia prevention bundle. American journal of infection control, 44(6), 652-656.
• Stubblefield, H., & Krucik, G. (2014). Hospital acquired nosocomial infection. J Preventive Infect Control, 43, 445-50.
• Sutandhio, S., Widodo, A. D. W., Alimsardjono, L., & Wasito, E. B. (2018). Perbandingan Distribusi Dan Pola Kepekaan Acinetobacter baumannii Terhadap Antimikroba Di RSUD Dr. Soetomo Surabaya Periode Januari–Maret 2015, April–Juni 2015, dan Januari–Maret 2016. Jurnal Widya Medika, 4(1), 18-23.
• Tablan, O. C., Anderson, L. J., Besser, R., Bridges, C., & Hajjeh, R. (2014). Guidelines for preventing health-care-associated pneumonia, 2003. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee.
• World Health Organization. (2019). Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (‎‎ MERS-CoV)‎‎ infection: interim guidance: updated October 2019 (No. WHO/MERS/IPC/15.1 Rev. 1). World Health Organization.
• Yazdani, M., Sabetian, G., Ra'ofi, S. H. A. H. I. N., Roudgari, A., & Feizi, M. (2015). A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit. Journal of Advances in Medical Education & Professionalism, 3(2), 68.
• Yazdannik, A., Atashi, V., & Ghafari, S. (2018). Performance of ICU nurses in providing respiratory care. Iranian journal of nursing and midwifery research, 23(3), 178.

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