Prevention of ventilator-associated pneumonia: Use of the care bundle approach

被引：40
作者：
Alcan, Aliye Okgun [1 ]
Korkmaz, Fatma Demir [1 ]
Uyar, Mehmet [2 ]
机构：
[1] Ege Univ, Fac Nursing, Izmir, Turkey
[2] Ege Univ, Fac Med, Izmir, Turkey
来源：
AMERICAN JOURNAL OF INFECTION CONTROL | 2016年 / 44卷 / 10期
关键词：
Adherence; evidence-based practices; mechanical ventilatory therapy; critical care nursing; UNIT; STRATEGIES; INFECTIONS; REDUCTION; TRENDS; IMPACT;
D O I：
10.1016/j.ajic.2016.04.237
中图分类号：
R1 [预防医学、卫生学];
学科分类号：
1004 ; 120402 ;
摘要：
Background: The ventilator-associated pneumonia (VAP) care bundle consists of evidence-based practices to improve the outcomes of patients receiving mechanical ventilatory therapy. This study aimed to investigate the implementation of the care bundle on VAP rates in this quasiexperimental study. Methods: The protocol of this study consisted of 3 phases. In the initial phase, observations were made to determine the VAP care bundle adherence of intensive care unit (ICU) nurses. In the second phase, education was provided to ICU nurses on the subject of the VAP care bundle. For the third phase, the effect of VAP care bundle adherence on the VAP rates after education was investigated. Results: The nurses' VAP care bundle adherence improved after education from 10.8% (n = 152) to 89.8% (n = 1,324) and showed statistically significant improvement (P =.0001 and P <.05). In this study, the VAP rates were determined as 15.91/10(3) ventilator-days before education and 8.50/10(3) ventilator days after education. It was found that the VAP rates after the education period were significantly lower than the VAP rates before education. Conclusion: VAP care bundle implementation with education prepared according to evidence-based guide-lines decreased VAP rates. Thus, implementation of the VAP care bundle on mechanically ventilated patients care is recommended. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码：E173 / E176
页数：4
相关论文
共 27 条
[1]   The results of a 6-year epidemiologic surveillance for ventilator-associated pneumonia at a tertiary care intensive care unit in Saudi Arabia [J].
Al-Dorzi, Hasan M. ;
El-Saed, Aiman ;
Rishu, Asgar H. ;
Balkhy, Hanan H. ;
Memish, Ziad A. ;
Arabi, Yaseen M. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2012, 40 (09) :794-799
[2]   Decreasing ventilator-associated pneumonia in adult intensive care units using the Institute for Healthcare Improvement bundle [J].
Al-Tawfiq, Jaffar A. ;
Abed, Mahmoud S. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2010, 38 (07) :552-556
[3]  
Alsadat Reem, 2012, Avicenna J Med, V2, P79, DOI 10.4103/2231-0770.110736
[4]   Eliminating Nosocomial Infections at Ascension Health [J].
Berriel-Cass, Dorine ;
Adkins, Frank W. ;
Jones, Polly ;
Fakih, Mohamad G. .
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY, 2006, 32 (11) :612-620
[5]   Adherence to Ventilator-Associated Pneumonia Bundle and Incidence of Ventilator-Associated Pneumonia in the Surgical Intensive Care Unit [J].
Bird, Dorothy ;
Zambuto, Amanda ;
O'Donnell, Charles ;
Silva, Julie ;
Korn, Cathy ;
Burke, Robert ;
Burke, Peter ;
Agarwal, Suresh .
ARCHIVES OF SURGERY, 2010, 145 (05) :465-470
[6]   Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit [J].
Blamoun, John ;
Alfakir, Maria ;
Rella, Marie E. ;
Wojcik, Janice M. ;
Solis, Roberto A. ;
Khan, M. Anees ;
DeBari, Vincent A. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2009, 37 (02) :172-175
[7]   Understanding and applying probabilities at the sickbed [J].
Brown, Samuel ;
Morris, Alan .
CRITICAL CARE MEDICINE, 2011, 39 (08) :2017-2018
[8]   Why don't physicians follow clinical practice guidelines? A framewouk for improvement [J].
Cabana, MD ;
Rand, CS ;
Powe, NR ;
Wu, AW ;
Wilson, MH ;
Abboud, PAC ;
Rubin, HR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (15) :1458-1465
[9]   Temporal Trends of Ventilator-Associated Pneumonia Incidence and the Effect of Implementing Health-care Bundles in a Suburban Community [J].
Ding, Shifang ;
Kilickaya, Oguz ;
Senkal, Serkan ;
Gajic, Ognjen ;
Hubmayr, Rolf D. ;
Li, Guangxi .
CHEST, 2013, 144 (05) :1461-1468
[10]   National Healthcare Safety Network (NHSN) report, data summary for 2012, Device-associated module [J].
Dudeck, Margaret A. ;
Weiner, Lindsey M. ;
Allen-Bridson, Katherine ;
Malpiedi, Paul J. ;
Peterson, Kelly D. ;
Pollock, Daniel A. ;
Sievert, Dawn M. ;
Edwards, Jonathan R. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2013, 41 (12) :1148-1166
123