Ventilator-associated pneumonia (vap) in intensive care unit : the role of vap bundle education in reducing its rates
| dc.contributor.author | Che Ishak, Zahniyah | |
| dc.date.accessioned | 2017-09-07T04:46:27Z | |
| dc.date.available | 2017-09-07T04:46:27Z | |
| dc.date.issued | 2013-04 | |
| dc.description.abstract | Introduction: Awareness and knowledge are important aspects of VAP prevention program. The participants have fair knowledge in VAP and VAP prevention. However, being knowledgeable does not assure implementation of evidence-based guideline, and guidelines adherence require the readiness to sustain that changed behavior. Study objective is to determine the effect of VAP-bundle educational program on nurses’ knowledge, practice, and incidence rate as well as factors associated with ventilator-associated pneumonia in ICU. Materials and methods: A prospective study on VAP was conducted in ICU with two study groups, ICU nurses and patients who are ventilated for 48 hours or more. Nurses who consented were subjected to selfadministered questionnaire before and after VAP-bundle educational program. While patient’s data before and after was collected from their medical records from early 2009 to early 2011. VAP was diagnosed based on Central for Disease Control and Prevention (CDC). The definition used for diagnosis was based on clinical and organisms isolated from tracheal aspirate. Result and discussion: Pre and post-intervention mean and standard deviation of participants score were fair but were significant different pre compared to post-intervention, [56.11 (2.82), 62.19 (2.70), mean score difference: 6.07 (4.95, 7.20) 95% CI, p < 0.001] respectively. Meanwhile the pre-intervention VAP rates were found to be reduced from 17.3 episodes per 1,000 ventilator-days to 7.0 episodes per 1,000 ventilatordays. The reduction rate was 59.5% but no significant association with VAP bundle interventions. It is associated with increased of the nurses’ skills in delivering of care related to oral care practices, maintaining of endotracheal tube cuff pressure, performing meticulous hands hygiene and infection control. After adjusting for cofounder, multiple logistic regression revealed that patients who undergo intrahospital transport are 7.2 times at risk to develop VAP compared to non-transport patients [Adjusted OR: 7.2, 95% CI: 2.46, 21.28, p < 0.001]. The main reasons for intrahospital transport were computed tomography scanning, and surgery. Meanwhile patients who have renal insufficiency are 5.7 times at risk to develop VAP [Adjusted OR: 5.7, 95% CI: 1.77, 18.84, p = 0.004]. Hortal et al. (2009) reported that patients who have creatinine levels of > 1.5 mg/dl were at risk to develop VAP (Hortal, Giannella, Pe'rez, et al., 2009). It is crucial to provide regular continuous nursing education program for at least 3-4 times a year to increase nurses’ awareness and knowledge on VAP prevention strategies. It is essential to explore the factors that contribute to the development of VAP for patients who have renal insufficiency and undergo intrahospital transportation in the ICU. Conclusion: There were significant reductions in VAP rate after intervention period. However the nurses’ knowledge on VAP and the prevention strategies were inadequate. Intrahospital transport and patient with renal insufficiency are more at risk to develop VAP. Keywords: nurses’ knowledge, ventilator-associated pneumonia, rate of ventilator-associated pneumonia, intrahospital transport, and renal insufficiency. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4515 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | nurses’ knowledge, ventilator-associated pneumonia, rate of ventilator-associated pneumonia, intrahospital transport, and renal insufficiency. | en_US |
| dc.title | Ventilator-associated pneumonia (vap) in intensive care unit : the role of vap bundle education in reducing its rates | en_US |
| dc.type | Thesis | en_US |
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