Impact of educational action in maintaining high decubitus as preventive measure of ventilator-associated pneumonia in the Intensive Care Unit

Abstract

Introduction: Intensive Care Unit (ICU) acquired pneumonia prolongs hospitalization and influences mortality rates. Educational interventions with health professionals are relevant preventive strategies for healthcare-associated infections. Objective: To evaluate the result of an educational activity on adherence to the maintenance of a high decubitus, above 30 degrees, as a measure for preventing ventilator-associated pneumonia. Methods: Quasi-experimental study with a pretestposttest design conducted in the ICU of the University Hospital of Londrina from March to June 2010, divided in three periods (preintervention, intervention and post-intervention). During study period, 49 health professionals were trained. Direct observations of the decubitus’ height were performed before and after training and clinical data of patients admitted to the ICU were collected. Adherence to the recommendation of high decubitus was defined as maintenance of decubitus above 30 degrees in each observation. Results: There was an increase in the mean of decubitus’ angle from pre-intervention period (27.85±6.76 degrees) to post-intervention (30.70±8.18 degrees; p<0.001), although this difference did not persisted in the third month postintervention observation (29.46±6.19 degrees). Conclusion: The educational activity was transiently effective in increasing adherence to maintain high decubitus during hospitalization, but the adherence decreased progressively, showing the need for a continuous intervention to maintain results.