Reduction in the Incidence of Poststroke Nosocomial Pneumonia by Using the “Turn-mob” Program
Received 14 October 2008; received in revised form 5 February 2009; accepted 11 February 2009.
Background
One of the most common complications in patients with acute ischemic stroke (AIS) is pneumonia, a complication that has an impact on the patient's survival. The purpose of this study was to establish whether the implementation of a passive turning and mobilization program can prevent the occurrence of nosocomial pneumonia (NP) in patients with AIS.
Methods
We conducted a randomized clinical trial. Patients diagnosed with AIS within the last 48 hours and without mechanical ventilation were included. Group A was the “turn-mob” program: turning and passive mobilization carried out by a previously trained relative. Group B was the control group: standard treatment characterized by turning carried out by the nursing staff. The purpose was to demonstrate whether the implementation of a manual turning and passive mobilization program could reduce the incidence of NP in patients with AIS during their stay at the hospital and up to 14 days after discharge.
Results
In all, 223 patients were included (group A, n = 111; group B, n = 112). Fourteen (12.6%) patients in group A and 30 (26.8%) in group B developed NP. The implementation of the turn-mob program was associated with a decrease in NP, with a relative risk of 0.39 (95% confidence interval .19-.79; P = .008).
Conclusion
The turn-mob program applied on patients during the acute phase of an ischemic stroke decreases the incidence of NP.
∗Clinical Epidemiology Medical Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS
†Clinical Epidemiology Unit, Hospital de Especialidades, Centro Médico Nacional Siglo, XII, IMSS
‡Clinical Epidemiology Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Universidad Autonóma del Estado de México Centro de Investigacíon en Ciencias Médicas
Address correspondence to Pilar Lavielle, PhD, Clinical Epidemiology Medical Unit, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Av Cuauhtemoc # 330, Col. Doctores, CP 06725, Distrito Federal, Mexico City, Mexico.
ABSTRACT