The effects of implementing preventive guidelines against ventilator-associated pneumonia in an isolation ward
Keywords:
ventilator-associated pneumonia, nursing practice guidelines, VAP prevention, incidence, VAPAbstract
Introduction: Ventilator-associated pneumonia (VAP) is a significant hospital-acquired infection and a major cause of patient mortality. Nursing interventions play a crucial role in preventing VAP.
Objective: To investigate the incidence of VAP and to assess the adherence to and satisfaction with the implementation of VAP prevention guidelines
Methods: This quasi-experimental study compared outcomes before and after implementing VAP prevention guidelines in nurses at isolation ward and patients who admitted to the isolation ward 9/5 at Nakornping Hospital between September 17, 2023, and January 2024. Nurse adherence and satisfaction with the guidelines were also evaluated. Data were analyzed using Fisher’s exact probability test, independent t-test, and incidence rate ratio (IRR) to determine the incidence of VAP.
Results: Before implementation, 40 patients were included, 64.00% male, with an average age of 61.67 ± 18.08 years. After implementation, 40 patients were included, 60.00% male, with an average age of 66.67±19.50 years. The incidence of VAP decreased following guideline implementation but was not statistically significant, from 22.84 to 11.83 cases per 1,000 ventilator days (IRR 0.52, 95% CI = 0.12–1.86, p=0.282). Thirteen nurses participated in the implementation, with an average age of 30.69±7.16 years and an average work experience of 7.92±7.48 years. Of the 23 recommended practices, 17 (73.91%) were fully adhered to, while 21 (91.30%) achieved over 90% adherence. The least-followed practice was an assessing readiness for ventilator weaning (46.15%). Nurse satisfaction with the guidelines was rated as very high across all aspects, with an average satisfaction score of 4.71±0.31.
Conclusion: The VAP prevention guidelines in this study demonstrated a trend toward reducing VAP incidence, although statistical significance was not achieved. Further studies with a larger sample size and longer duration are recommended. Nevertheless, the observed clinical reduction in VAP incidence is relevant to patient outcomes and healthcare costs, supporting the continued use of these guidelines with long-term follow-up.
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