The Effectiveness of the Clinical Nursing Guidelines for Preventing Pneumonia Associated with Mechanical Ventilation on Incidence Rate of Ventilator-Associated Pneumonia, Sawanpracharak Hospital
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Published:
Dec 31, 2018
Keywords:
Pneumonia Ventilator Clinical nursing practice guideline
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Abstract
The two group post test quasi-experimental design was conducted to determine the effectiveness of the clinical nursing guidelines for preventing pneumonia associated with mechanical ventilation on incidence rate of ventilator associated pneumonia. The samples consisted of 52 patients with mechanical ventilation in Sawanpracharak hospital, Nakornsawan province, 26 of which, were intervention group receiving nursing care following the clinical nursing practice guidelines for preventing pneumonia associated with mechanical ventilation and 26 of which, were control group receiving conventional nursing care. Data were collected from October 1, 2018 to December 31, 2018. Data were analyzed using descriptive statistics, chi-square test and fisher’s exact test.
The findings showed that the mean age of the patients in intervention group was 56.7 years (SD= 14.7), the mean duration of mechanical ventilation was 10.7 days (SD = 4.6). The mean age of the patients in the control group was 53.6 years (SD = 15.9), the mean duration of mechanical ventilation was 9.6 days (SD = 4.1). The incidence of ventilator associated pneumonia (VAP) of patients in the intervention group and the control group was 3.8 and 23.0 percent. It was found that the incidence of VAP in the intervention group were significantly lower than the control group (p<0.05). The effectiveness of the clinical nursing guidelines for prevention of ventilator associated pneumonia was 83.55 percent. There was an observable decrease in the occurrence of ventilator associated pneumonia from 23.1 to 3.8 percent.
The findings indicated that the clinical nursing guidelines for preventing pneumonia associated with mechanical ventilation decreased the incidence of ventilator associated pneumonia. Therefore, utilization of this clinical nursing practice guideline is recommended in order to improve the quality of nursing care.
The findings showed that the mean age of the patients in intervention group was 56.7 years (SD= 14.7), the mean duration of mechanical ventilation was 10.7 days (SD = 4.6). The mean age of the patients in the control group was 53.6 years (SD = 15.9), the mean duration of mechanical ventilation was 9.6 days (SD = 4.1). The incidence of ventilator associated pneumonia (VAP) of patients in the intervention group and the control group was 3.8 and 23.0 percent. It was found that the incidence of VAP in the intervention group were significantly lower than the control group (p<0.05). The effectiveness of the clinical nursing guidelines for prevention of ventilator associated pneumonia was 83.55 percent. There was an observable decrease in the occurrence of ventilator associated pneumonia from 23.1 to 3.8 percent.
The findings indicated that the clinical nursing guidelines for preventing pneumonia associated with mechanical ventilation decreased the incidence of ventilator associated pneumonia. Therefore, utilization of this clinical nursing practice guideline is recommended in order to improve the quality of nursing care.
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อินทร์จันทร์ ธ., ศรชัย น., & ยอดนิล ว. (2018). The Effectiveness of the Clinical Nursing Guidelines for Preventing Pneumonia Associated with Mechanical Ventilation on Incidence Rate of Ventilator-Associated Pneumonia, Sawanpracharak Hospital. Journal of Bamrasnaradura Infectious Diseases Institute, 12(3), 146–156. retrieved from https://he01.tci-thaijo.org/index.php/bamrasjournal/article/view/185753
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Original Articles
References
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2. Spalding MC, Cripps MW, Minshall CT. Ventilator-associated pneumonia: New definitions. Crit Care Clin 2017; 33(2): 277-92.
3. Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC. Ventilator associated pneumonia: a review. Eur J Intern Med 2010; 21(5): 360-8.
4. Soussan R, Schimpf C, Pilmis B, Degroote T, Tran M, Bruel C. Ventilator associated pneumonia: The central role of transcolonization. J Crit Care 2019;ท(50): 155-61.
5. Tsioutis C, Kritsotakis EI, Karageorgos SA, Stratakou S, Psarologakis C, Kokkini S, et al. Clinical epidemiology, treatment and prognostic factors of extensively drug-resistant Acinetobacter baumannii ventilator-associated pneumonia in critically ill patients. Int J of Antimicrob Agents 2016; 48(5): 492-7.
6. Chaari A, Mnif B, Bahloul M, Mahjoubi F, Chtara K, Turki O, et al. Acinetobacter baumannii ventilator-associated pneumonia epidemiology, clinical characteristics, and prognosis factors. Int J Infect Dis 2013; 17(12): e1225-8.
7. Fihman V, Messika J, Hajage D, Tournier V, Gaudry S, Magdoud F, et al. Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption. Int J Antimicrob Agents 2015; 46 (5): 518-25.
8. Inchai J, Liwsrisakun C, Theerakittikul T, Chaiwarith R, Khositsakulchai W, Pothirat C. Risk factors of multidrug-resistant, extensively drug-resistant and pandrug-resistant Acinetobacter baumannii ventilator-associated pneumonia in a medical Intensive care unit of university hospital in Thailand. J Infect Chemother 2015; 21(8): 570-4.
9. Hayashi Y, Morisawa K, Klompas M, Jones M, Bandeshe H, Boots R, et al. Towards improved surveillance: the impact of ventilator-associated complications (VAC) on length of stay and antibiotic use in patients in intensive care units. Clin Infect Dis 2012; 56(4): 471-7.
10. Khan R, Al-Dorzi HM, Al-Attas K, Ahmed FW, Marini AM, Mundekkadan S, et al. The impact of implementing multifaceted interventions on the prevention of ventilator associated pneumonia. Am J Infect Control 2016; 44(3): 320-6.
