Effectiveness of used new VAP bundle on the incidence of ventilator associated pneumonia in neonatal intensive unit
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Abstract
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common infection among neonates worldwide. Chiangrai Prachanukroh Hospital has reported a consistently high incidence of neonatal VAP during 2020–2022, with rates of 14.44, 10.47, and 10.98 per 1,000 ventilator days, respectively. Since January 2023, the hospital has implemented a new VAP bundle based on the SHEA 2022 recommendations. It was found that nurses had varying levels of knowledge and practice, particularly among those with less than five years of experience.
OBJECTIVE: To compare the knowledge and incidence of VAP in neonates before and after promoting knowledge and improving practices of the new VAP bundle, and to examine nurses’ compliance with the VAP bundle in neonatal patients.
METHODS: This study employed a historical control design. The samples included 12 registered nurses and 202 neonates (127 in the control group and 75 in the study group) in the Neonatal Intensive Care Unit between November 2023 and December 2024. Research instruments consisted of data record forms, a teaching manual, a knowledge assessment, and a new VAP bundle practice observation form. Data were analyzed using descriptive statistics, the exact probability test, and the t-test.
RESULTS: After the promotion of knowledge and practice of the new VAP bundle, the incidence of VAP decreased from 29.9% to 16% (p=0.029), while the nurses’ mean knowledge score increased and their practice score improved from 93.1% to 95.5% (p=0.016).
CONCLUSIONS AND RECOMMENDATIONS: Promoting knowledge and enhancing nurses’ skills in the new VAP bundle effectively reduced the incidence of VAP. The findings should be applied to develop practice guidelines for neonates in units with similar contexts.
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