Department of Nursing Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Singapore Med J. 2013 May;54(5):281-4. doi: 10.11622/smedj.2013109.
Ventilator-associated pneumonia (VAP) is a common risk among critically ill ventilated patients. This study aimed to investigate the effects of nurse-led education on: (a) knowledge of and compliance with ventilator care bundle (VCB) practices among intensive care unit (ICU) nurses; and (b) reduction in the rates of VAP post intervention.
A quasi-experimental design with pretest-posttest evaluation and observation was used to investigate nurses' knowledge of and compliance with VCB practices, and the incidence of VAP. The study was conducted among 71 nurses, and the intervention involved structured education on VAP and its prevention using VCB in an ICU setting. Data were analysed using descriptive and inferential statistics.
Nurse-led education significantly increased nurses' knowledge of (t[70] = -36.19; p < 0.001) and compliance with (t[65] = -21.41; p < 0.001) VCB practices. The incidence of VAP, which was 39 per 1,000 ventilator days during the two-month period before intervention, dropped to 15 per 1,000 ventilator days during the two-month period following intervention.
Our findings show that nurse-led education on VAP and VCB significantly increased knowledge of and compliance with VCB practices among ICU nurses, and was associated with a reduction in the incidence of VAP among intubated and mechanically ventilated ICU patients. Inclusion of recent knowledge and evidence-based VCB guidelines for VAP prevention when educating anaesthetists, nurses, physiotherapists and other healthcare providers in the critical care setting is recommended.
呼吸机相关性肺炎(VAP)是重症监护病房中接受机械通气的患者常见的风险。本研究旨在调查护士主导的教育对以下方面的影响:(a)重症监护病房(ICU)护士对呼吸机护理包(VCB)实践的知识和依从性;以及(b)干预后 VAP 发生率的降低。
采用准实验设计,进行前测-后测评估和观察,以调查护士对 VCB 实践的知识和依从性以及 VAP 的发生率。研究对象为 71 名护士,干预措施包括在 ICU 环境中使用 VAP 及其预防的 VCB 对护士进行结构化教育。使用描述性和推断性统计方法分析数据。
护士主导的教育显著提高了护士对 VCB 实践的知识(t[70] = -36.19;p < 0.001)和依从性(t[65] = -21.41;p < 0.001)。在干预前两个月,每千台呼吸机日的 VAP 发生率为 39 例,而在干预后两个月,这一数字降至每千台呼吸机日 15 例。
我们的研究结果表明,对 VAP 和 VCB 的护士主导教育显著提高了 ICU 护士对 VCB 实践的知识和依从性,并且与接受机械通气的 ICU 患者 VAP 发生率的降低有关。建议在 ICU 环境中对麻醉师、护士、物理治疗师和其他医疗保健提供者进行教育时,纳入最新的知识和基于证据的 VCB 指南以预防 VAP。