Lessons learned from a rapid implementation of a ventilator-associated pneumonia prevention bundle.

BACKGROUND

Ventilator-associated pneumonia (VAP) is a common avoidable healthcare associated infection in ventilated critical care patients that can have a detrimental impact on patient recovery. To increase uptake at a local level, care bundles should be designed and implemented in collaboration with the end-users who will implement the bundle into practice.

AIM/OBJECTIVE: The aim in this study was to evaluate critical care nurses' perceptions of the usability of a respiratory care bundle as an effective approach to VAP prevention.

METHODS

An exploratory descriptive qualitative study was conducted. A respiratory care bundle consisting of five components was implemented over a 4-week period. Following implementation, a focus group and semi-structured interviews were conducted to obtain nurses' feedback on the useability of the care bundle. Seven intensive care nurses caring for ventilated patients participated in the study.

FINDINGS/RESULTS: Participants confirmed that using a care bundle provided a structured approach to nursing care of a ventilated patient and that the use of checklist reminders at the bedside was useful in a busy practice environment. Barriers to uptake and implementation of the bundle were that the unit culture did not prioritise preventative care and the need for a structured interdisciplinary approach to sedation and weaning of mechanical ventilation.

DISCUSSION

To successfully imbed all elements of a respiratory care bundle into practice; an interdisciplinary approach is needed in which there is a strong emphasis on preventative care. These findings highlight the advantages of involving end-users in the development of strategies to decrease VAP.