Research Article
Volume 4 Issue 3 - 2020
Ventilator Associated Pneumonia and Hand Hygiene Compliance in Trauma Intensive Care Units
Mohsen Savaie1*, Farid Zand2, Mansoor Masjedi3, Golnar Sabetian4, Behzad Maghsoudi5 and Monireh Feizi6
1Anesthesiologist, Intensivist, Assistant Professor of Anesthesiology and Critical Care Medicine, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2Anesthesiologist, Intensivist, Professor of Anesthesiology and Critical Care Medicine, Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3Anesthesiologist, Intensivist, Associate Professor of Anesthesiology and Critical Care Medicine, Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4Associate Professor of Anesthesiology and Critical Care Medicine, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
5Associate Professor of Anesthesiology and Critical Care Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6Nurse (RN), Infection Control Supervisor, Shahid Rajaie Trauma Center, Shiraz University of Medical Sciences, Shiraz, Iran
*Corresponding Author: Mohsen Savaie, Anesthesiologist, Intensivist, Assistant Professor of Anesthesiology and Critical Care Medicine, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Received: January 20, 2020; Published: February 08, 2020


Introduction: Prevention of ventilator associated pneumonia in critically ill patients is very important and one of the most determinants in this way is hand hygiene compliance. Nurses who take care of the patient and staff who are in contact with the patient for any reason should be aware of the importance and methods of ventilator associated pneumonia and have been trained in this field. In this study, we investigated the knowledge of intensive care units staff about prevention methods of ventilator associated pneumonia. We also evaluated the hand hygiene compliance as one of the most important preventive factors.

Materials and Methods: We designed a descriptive study in which, the nursing staff knowledge verified by a reliable and valid questionnaire. We used observational method to check the hand hygiene compliance using a standard checklist prepared by the center for disease control (CDC).

Results: The rate of hand hygiene compliance among the staff was 48.4 ± 5%. Knowledge assessment of nursing staff regarding prevention methods of ventilator associated pneumonia, revealed that their mean acquired score was 6.1 ± 1.67 of 10.

Conclusion: In spite of the training and emphasis placed on hand hygiene in our intensive care units, there is a need for more supervision in this area for more compliance. Nursing staff awareness about prevention methods of ventilator associated pneumonia is not desirable, and we need more training in this field.

Keywords: Intensive Care Unit; Ventilator Associated Pneumonia; Hand Hygiene; Training; Personnel Awareness


  1. Centers for Disease Control and Prevention. Pneumonia (ventilator associated [VAP] and non-ventilator-associated pneumonia [PNEU]) event. Device-associated Module PNEU/VAP (2015). 
  2. Robbins RA. “CDC releases ventilator-associated events criteria”. Southwest Journal of Pulmonary and Critical Care 14.1 (2017): 40-41.
  3. Demirdal T., et al. “Is inhaled colistin beneficial in ventilator associated pneumonia or nosocomial pneumonia caused by Acinetobacter baumannii?” Annals of clinical microbiology and antimicrobials 15.1 (2016): 1.
  4. Montravers P., et al. “Current and Future Considerations for the Treatment of Hospital-Acquired Pneumonia”. Advances in therapy 33 (2016): 151-66.
  5. Klompas M., et al. “Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update”. Infection Control and Hospital Epidemiology 35.8 (2014): 915-936.
  6. Nseir S., et al. “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 (2011): 1041-1047.  
  7. Steven Deem and Miriam M Treggiari. “New Endotracheal Tubes Designed to Prevent Ventilator-Associated Pneumonia: Do They Make a Difference?” Respiratory Care 55.8 (2010): 1046-1055.
  8. Doyle A., et al. “The incidence of ventilator-associated pneumonia using the PneuX System with or without elective endotracheal tube exchange: A pilot study”. BMC Research Notes 4.1 (2011): 1.
  9. Hudson JK., et al. “Impact of subglottic suctioning on the incidence of pneumonia after cardiac surgery: a retrospective observational study”. Journal of Cardiothoracic and Vascular Anesthesia 29.1 (2015): 59-63.
  10. Damas P., et al. “Prevention of ventilator-associated pneumonia and ventilator-associated conditions: a randomized controlled trial with subglottic secretion suctioning”. Critical Care Medicine 43.1 (2015): 22-30.
  11. Wang F., et al. “Subglottic secretion drainage for preventing ventilator-associated pneumonia: an updated meta-analysis of randomized controlled trials”. Journal of Trauma and Acute Care Surgery 72.5 (2012): 1276-1285.
  12. Frost SA., et al. “Subglottic secretion drainage for preventing ventilator associated pneumonia: a meta-analysis”. Australian Critical Care 26.4 (2013): 180-188.
  13. Dezfulian C., et al. “Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis”. The American Journal of Medicine 118.1 (2005 ): 11-18.
  14. Juneja D., et al. “Comparing influence of intermittent subglottic secretions drainage with/without closed suction systems on the incidence of ventilator associated pneumonia”. Indian Journal of Critical Care Medicine 15.3 (2011): 168.
  15. Masjedi Mansoor., et al. “Early replacement of conventional endotracheal tube with endotracheal tube with subglottic suction port for the new intensive care patients preventive or problematic against ventilator associated events?” Journal of Pure and Applied Microbiology 10.4 (2016): 2655-2663.         
  16. Williams TA. “Is the evidence for the use of subglottic drainage to prevent ventilated-associated pneumonia sufficient to change practice?” Australian Critical Care 25.3 (2012): 200-204.
  17. Yeganeh M., et al. “Knowledge of evidence‐based guidelines in Ventilator‐Associated Pneumonia prevention”. Journal of Evidence‐Based Medicine (2016).
  18. Al-Sayaghi KM. “Prevention of ventilator-associated pneumonia A knowledge survey among intensive care nurses in Yemen”. Saudi medical journal 35.3 (2014): 269-276.
  19. Safdari R., et al. “Effect of intermittent subglottic secretion drainage on ventilator-associated pneumonia: A clinical trial”. Iranian Journal of Nursing and Midwifery Research 19.4 (2014): 376.
  20. Blot SI., et al. “Executive Board of the Flemish Society for Critical Care Nurses. Evidence-based guidelines for the prevention of ventilator-associated pneumonia: results of a knowledge test among intensive care nurses”. Intensive Care Medicine 33.8 (2007): 1463-1467.
  21. Tolentino-de los Reyes AF., et al. “Ventilator associated pneumonia evidence-based practice: use of the ventilator bundle to prevent”. American Journal of Critical Care 16 (2007): 20-27.
  22. Hamishehkar H., et al. “Education alone is not enough in ventilator associated pneumonia care bundle compliance”. Journal of Research in Pharmacy Practice 3.2 (2014): 5
  23. Masjedi M., et al. “Early replacement of conventional endotracheal tube with endotracheal tube with subglottic suction port for the new intensive care patients preventive or problematic against ventilator associated events?” Journal of Pure and Applied Microbiology 10.4 (2016): 2655-2662.
Citation: Mohsen Savaie., et al. “Ventilator Associated Pneumonia and Hand Hygiene Compliance in Trauma Intensive Care Units”. EC Emergency Medicine and Critical Care 4.3 (2020): 01-06.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before November 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to