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评估私立医院重症监护病房中呼吸机相关性肺炎(VAP)预防 bundle 的知识掌握情况和实施实践。

Assessment of knowledge and implementation practices of the ventilator acquired pneumonia (VAP) bundle in the intensive care unit of a private hospital.

机构信息

Division of Infectious Diseases, Department of Medicine, University of the Philippines Manila, Philippine General Hospital, Manila, Philippines.

Section of Infectious Diseases, Department of Medicine, The Medical City, Ortigas Avenue, Pasig, Philippines.

出版信息

Antimicrob Resist Infect Control. 2021 Nov 12;10(1):161. doi: 10.1186/s13756-021-01027-1.

Abstract

Studies have shown that a ventilator associated pneumonia (VAP) bundle significantly decreases VAP rates. In this study, we evaluated existing knowledge, practices, and adherence of nurses and infection control preventionists (ICP) to the VAP bundles of care in the intensive care unit (ICU) by using qualitative and quantitative tools. Of 60 participants (56 nurses and 4 ICPs), mean knowledge score regarding specific evidence-based VAP guidelines was 5 (range 3-8) out of 10 points. Self-reported adherence to the VAP bundle ranged from 38.5 to 100%, with perfect compliance to head of bed elevation, and poorest compliance with readiness to extubate. Overall VAP median bundle compliance was 84.6%. Knowledge regarding specific components of VAP prevention is lacking. Formal training and interactive educational sessions should be performed regularly to assess the competency of key personnel regarding the VAP bundle, especially in the context of rapid nurse turnover. Incentives for retention of nurses should also be considered, so that knowledge of hospital specific initiatives such as the VAP bundles of care can be cultivated over time.

摘要

研究表明,呼吸机相关性肺炎(VAP)预防 bundle 可显著降低 VAP 发生率。本研究采用定性和定量工具,评估了重症监护病房(ICU)护士和感染预防控制专家(ICP)对 VAP 护理 bundle 的现有知识、实践和依从性。在 60 名参与者(56 名护士和 4 名 ICP)中,针对特定基于证据的 VAP 指南的知识评分平均为 10 分中的 5 分(范围 3-8 分)。自我报告的 VAP bundle 依从性范围为 38.5%至 100%,床头抬高的完全依从性和准备拔管的依从性最差。总体 VAP 中位 bundle 依从性为 84.6%。关于 VAP 预防具体内容的知识有所欠缺。应定期进行正式培训和互动式教育课程,以评估关键人员对 VAP bundle 的能力,特别是在护士快速更替的情况下。还应考虑对护士的留用激励措施,以便随着时间的推移,培养对医院特定举措(如 VAP 护理 bundle)的了解。

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