The development of a nursing system for preventing of ventilator associated pneumonia
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Abstract
Abstract
This research and development aimed to develop the nursing system for prevention of ventilator associated pneumonia and identify outcomes of utilizing this system in the General Medical Ward. The research was conducted between February 2018 and December 2019. The population of this study was purposive sampling. The population was 1,085 patients using ventilators who admitted in general medical wards, Ratchaburi Hospital and 98 nurses caring these patients. The research comprised of the analysis of the existing situations using the root cause analysis and the system development and trials using the Deming’s cycle. The outcomes evaluated for the rate of ventilator associated pneumonia, the competencies and motivation of practicing, Data were analyzed using descriptive statistics including percentage, mean and standard deviation
The results showed that the nursing system for prevention of ventilator associated pneumonia comprised of three guidelines; 1) the nursing workforce administration, 2) the nursing care for prevention of ventilator associated pneumonia (VAP Bundle Care), and 3) the supervision of nursing care. The outcomes after the system utilization showed that the system was appropriate. One hundred and eighty-five patients became ventilator associated pneumonia 2.38 times per 1,000 ventilator days. Ninety-five registered nurses had the average scores of competencies and motivation in practicing for prevention of ventilator associated pneumonia being at the high levels (mean and standard deviation 3.61 ± 0.38 and 4.03 ± 0.59).Recommendation: The system should be applied to other general wards which have the patients using ventilators.
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References
References
Center of Disease Control. Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event [Internet]. 2017. [cited 2019 Jan 3]. Device-associated Module PNEU/VAP,1-17. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/ 6pscvapcurrent.pdf
Lim KP, Kuo SW, Ko W J, Sheng WH, Chang YY, Hong, et al. Efficacy of ventilator-associated pneumonia care bundle for prevention of ventilator-associated pneumonia in the surgical intensive care units of a medical center. Clin Microbiol Rev 2015; 48(3):316-21.
Bonell A, Azarrafiy R, Huong VTL, Viet L, Phu VD, Dat VQ, et al. A systematic review and meta-analysis of ventilator associated pneumonia in adults in asia: An analysis of national income level on incidence and etiology. Clin Infect Dis 2019:68(1):5141-518.
Leethong, P. Hospital acquired pneumonia and ventilator associated pneumonia in adults at Samutprakarn Hospital: Etiology clinical outcomes and impact factors of antimicrobial resistance. Reg 11 Med J;33(2):181-196.
Ladbrook E, Khaw D, Bouchoucha S, Hutchinson A. A systematic scoping review of the cost-impact of ventilator-associated pneumonia (VAP) intervention bundles in intensive care. Am J Infect Control 2020:1-9. doi.org/10.1016/j.ajic.2020.11.027
Li L, Wang Q, Wang J, Liu K, Wang P, Li X. et al. Development, validation and application of a ventilator- associated pneumonia prevention checklist in a single cardiac surgery centre. Intensive Crit Care Nurs 2018;8(2):1645-7.
Li J, Xie D, Li A, Yue J. Oral topical decontamination for preventing ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled. J Hosp Infect 2013; 84(4):283-93.
Wang L, Li X, Yang Z, Tang X, Yuan Q, Deng L, et al. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database Syst Rev 2016, Issue 1. Art. No.: CD009946. DOI: 10.1002/14651858.CD009946.pub2.
Qahtani A.A. Inappropriate Endotracheal Tube (ETT) cuff pressure and its relation to ventilator-associated pneumonia (VAP) in Intensive care unit (ICU). Eur Respir J 2020;56:2026
Atashi V, Yousefi H, Mahjobipoor H, Yazdannik A. The barriers to the prevention of ventilator – associated pneumonia from the perspective of critical care nurses: A qualitative descriptive study. J Clin Nurs 2018;27(Isuue 5-6):e1161-e1170
Centers for Disease Control and Prevention. Guideline for preventing health-care-associated pneumonia. [Internet]. 2003. [cited 2019 Jan 3]. Available from: http://www.cdc. gov/hicpac/pdf/guidelines/HApneu2003 guidelines.pdf
Medical nursing group, Ratchaburi Hospital. Annual report 2018. Ratchaburi: Ratchaburi hospital; 2018.
Prajongtas N, Jamnam U. Efficiency on the use and care of patients using volume-controlled ventilators of professional nurses, general medicine ward. Research Report 2015.
Bertalanfft LV. General systems theory. In: Hammond D, editor. The science of synthesis exploring the social implication of general systems theory. [Internet]. 2010. USA: The university press of Colorado. p.103-42. [Internet]. 2010. [cited 2019 Mar 3]. Available from: https://scholar.google.co.th/
Ministry of Public Health. Motivation moral and satisfaction in working of health personnel questionnaire. [Internet]. 2015. [cited 2019 Jan 25]. Available from: kpo.moph.go.th/ webkpo/dl_ meeting/F20120601084129.doc
Sanguannam J. Theory and practice in educational institution. 3rd ed. Bangkok: Book point; 2010.
Jumnearsuk S, Binhosen V, Pakdevong N. Development of nursing practice system implementation protocol for prevention of ventilator associated pneumonia among patients in surgical ward. RSU National Research Conference 2015 [Internet]. 2015. [cited 2021 Jan 3]. Available from: https://rsucon.rsu.ac.th/files/proceedings/nation2015/G1-28.pdf
Ritklar L, Saiphoklang N. Results of promoting the clinical nurse practice guidelines for mechanically ventilated patients and incidence of ventilator-associated pneumonia in a medical ward at Thammasat University Hospital. Nursing Journal 2015;42:95-104.
Doungartid N. The development of a patient care system using the assignment model of a team of nurses who are owned by fever in the male ward, Damnoen Saduak Hospital. [Internet]. 2015. [cited 2021 Jan 3]. Available from: http://www.dnhospital.go.th/dnweb/ phocadownload/ med.pdf.
Thoopkaew K. The effect of clinical supervision on knowledge Competence in nursing practice to prevent ventilator associated pneumonia and satisfaction with supervision clinic of professional nurses [Thesis]. Bangkok: Rangsit University; 2010.
Amphiwan N, Hingkanont P, Prajanban P. The relationship between leadership behaviors and contribute motivation by perception of staff nurses in Buddachinaraj Phitsanulok Hospital Journal of Nursing and Health Sciences 2011;5(3):65-79.
Kanyana B, Abhicharttibutra K, Chitpakdee B. Nurses’ motivating language and registered nurses’ job performance, government university. Nursing Journal 2020;47(2):320-32.
