School of Nursing, Al Al-Bayt University, Mafraq, Jordan.
Nurs Crit Care. 2018 May;23(3):147-151. doi: 10.1111/nicc.12323. Epub 2017 Nov 15.
Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable.
The purpose of this study was to assess nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that influence their compliance.
A structured observational design with a non-participant approach.
One hundred nurses were observed during their care for patients on mechanical ventilator. The observers documented nurses' implementation of ventilator-associated pneumonia prevention guidelines using a structured observational sheet.
Compliance of nurses was found to be unsatisfactory. Of the participants, 63% showed 'insufficient compliance'. Nurses working in units with a 1:1 nurse:patient ratio and lower beds' capacity demonstrated higher compliance and their intensive care units had a lower rate of ventilator-associated pneumonia and shorter intensive care unit stay in comparison with their counterparts working with a 1:2 nurse:patient ratio and higher beds' capacity.
Nurses' compliance with ventilator-associated pneumonia prevention guidelines was insufficient. Low nurse-patient ratio and large intensive care unit beds capacity were found to affect nurses' compliance and patients' outcomes. This study expanded knowledge about important aspects of nursing care; nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that affect their compliance. This knowledge can be used by health professional to guide the clinical practice and to improve the quality of care.
为了降低临床环境中呼吸机相关性肺炎的发生率，疾病预防控制中心、美国胸科学会和医疗改进研究所发布了呼吸机相关性肺炎预防指南；然而，护士对这些指南的依从性仍存在疑问。
本研究旨在评估护士对呼吸机相关性肺炎预防指南的依从性以及影响其依从性的因素。
采用非参与者结构观察设计。
在对机械通气患者进行护理期间，观察了 100 名护士。观察者使用结构化观察表记录护士实施呼吸机相关性肺炎预防指南的情况。
发现护士的依从性不尽如人意。在参与者中，有 63%的人表现出“依从性不足”。与 1:2 护士:患者比例和高床位数的护士相比，在 1:1 护士:患者比例和低床位数的单位工作的护士表现出更高的依从性，他们所在的重症监护病房呼吸机相关性肺炎的发生率更低，重症监护病房的停留时间更短。
护士对呼吸机相关性肺炎预防指南的依从性不足。低护士与患者比例和大重症监护病房床位数被发现会影响护士的依从性和患者的结果。本研究扩展了关于护理重要方面的知识；护士对呼吸机相关性肺炎预防指南的依从性以及影响其依从性的因素。这些知识可以被卫生专业人员用来指导临床实践和提高护理质量。
