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The use of closed system-suctioning (CSS) is more effective
than open system-suctioning (OSS) in preventing VAP (ventilator-associated pneumonia)?
False
Even though it might seem that CSS would be a better system to prevent VAP; research has shown that both CSS and OSS can be used effectively.
The following two review articles concluded that there were no significant differences in the incidence of ventilator-associated pneumonia but both review articles suggest further research to validate the results of their analysis.
- Jongerden IP, Rovers MM, Grypdonck MH, Bonten MJ. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis. Crit Care Med. 2007 Jan;35 (1):260-70.
- Subirana M, Solà I, Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004581.
The Institute for Healthcare Improvement (IHI) developed the concept of “bundles” to help health care providers more reliably deliver the best care possible for their patients. One such “bundle” addresses VAP. These strategies are evidence-based and represent the present standard of care for ventilated patients and have shown dramatic reductions in the incidence of ventilator-associated pneumonia. Interestingly the bundles do not recommend a specific system of suctioning.
For a more complete discussion on VAP and its prevention review the following websites and guidelines:
- Institute for Healthcare Improvement - Ventilator Bundle
- IHI Bundle How-to Guide - Prevent Ventilator-Associated Pneumonia
- Tablan OC, Anderson LJ, Besser R, et al. CDC; Healthcare Infection Control Practices Advisory Committee. Guidelines for preventing health-care-associated pneumonia, 2003: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004;53(RR-3):1-36.
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Institute of Healthcare Improvement
5 million lives campaign
The 5 Million Lives Campaign is a voluntary initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008).
- IHI 5 Million Lives Website
- Overview
- Participants
- Implement the Central Line Bundle
- IHI Getting Started Kit: Prevent Ventilator-Associated Pneumonia How-to Guide
Center for Disease Control and Prevention (CDC)
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
- CDC Guidelines for Preventing Health-Care--Associated Pneumonia
- CDC Hand Hygiene in Healthcare Settings
- CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections
- CDC Hand Hygiene in Healthcare Settings
