Effects of the WHAPO-CRE Clinical Nursing Practice Guideline among Intubated Patients
This non randomized controlled trial aimed to evaluate the effects of the WHAPO-CRE Clinical Nursing Practice Guideline (WHAPO-CRE CNPG) among intubated patients. Two groups of participants were purposively selected for the study including 1) 112 intubated patients with mechanical ventilation which were equally divided into experimental and comparison groups and 2) 43 registered nurses caring for intubated patients at the RCU and MICU-LT units of Maharat Hospital. Research tools consisted of the WHAPO-CRE CNPG, CRE risk assessment form, VAP-CRE monitoring form, nurse ’s competency in CNPG assessment form, CNPG adherence form and CNPG satisfaction form. Descriptive statistics were used to summarized data to yield frequencies, percentages, mean and standard deviation. Cox proportional hazard regressions were used to estimate risks of developing VAP-CRE Results showed that both experimental and comparison group patients did not develop early-onset VAP-CRE. Comparison group patients developed late-onset VAP-CRE incidence 9.68/1,000 ventilator-day compared among experimental group patients incidence 3.21/1,000 ventilator-day. Comparison groups patients were 2.59 times more likely to develop late-onset VAP-CRE (Crude HR=2.59, 95% CI: 0.27-24.91). Moreover, nurses implementing the CNPG demonstrated high level of competency with 91.42% accuracy in using WHAPO-CNPG and 83.33%
accuracy in using CRE-CNPG. They also reported high level of WHAPO-CNPG adherence (91.8%) and CRE-CNPG
adherence (83.33%). Lastly, nurses were highly satisfied with the WHAPO-CRE CNPG (82.32%). Results from
this study indicated that the WHAPO-CRE CNPG was effective in reducing VAP-CRE incidence and showed
feasibility to be used in actual clinical settings.
2018; 24, 30-142.
2. BenjamasThamcharoentrakul&SaensomDonwiwat. Effects of using nursing practice guideline for ventilator associated pneumonia prevention: medical department. The Journal of Borommarajonani college of nursing Nakhonratchasima 2018;25, 1-18.
3. Centers for Disease control and prevention. Facility Guidance for control of carbapenem-resistant Enterobacteriaceae (CRE) November 2015 Update - CRE Toolkit. [database on the Internet]. 2015 [cited 2018 November]. Available from https://www.cdc.gov/hai/pdfs/cre/CRE-guidance-508.pdf
4. Fitch, Z.W. & Whitman, G.J.R. Incidence, Risk, and Prevent of ventilator -associated pneumonia in adult cardiac surgical patients: A Systematic Review. J Card Surg2014;29: 196-203.
5. Jena, S. et al. Comparison of suction above cuff and standard endotracheal tubes in neurological patients for the incidence of ventilator-associated pneumonia and in- hospital outcome: A randomized controlled pilot study. Indian Journal of Critical Care Medicine2016; 20(5): 264-266.
6. KarmmukKanokphan, Kusuma Ayutthaya Sasima, &PinyopatsakulWonpeng. Oral care practice guideline in critically ill patients to prevent ventilator-associated pneumonia. Journal of Nursing Division 2019; 18(2): 1-11.
7. Munoz-Price, Mary K. Hayden, Karen Lolans,Sarah Won. Successful control of an outbreak of Klebsiella pneumonia Carbapenemase producing K.pneumoniae at a Long-Term Acute Care Hospital. Infection control &Hospital Epidemiology 2010; 31(4):341-347.
8. Perez Granda, M.J., Barrio, J.M., Hortal, J. Munoz, P. Rincon, C. &Bouza, E. Routine aspiration of subglottic secretions after majorly: impact on the incidence. J Hosp Infect2013; 85(4): 312-5.
9. PreudtiwatKulada, WongsaenRatchanee, ThanompanSuttiphun, &TariyoSamattanet. The effectiveness enhancement of patient care to reduce multi-drug resistance infection in medical and surgical department Nakornping Hospital. Journal of Nursing Division 2017; 44(3):10-33.
10. SakuneeSakeam,&KamrumPontrip. Infectious disease in hospital in Khonkaen hospital pediatric department. KhonKaen Journal 2008; 31, 144-155.
11. WisansawatJarukon.Carbapenem resistance of gram-negative bacteria resistance to multiple antimicrobial drug in MaharatNakhonratchasima hospital2009; 32, 19-28.
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