Effects of Clinical Nursing Practice Guidelines for Preventing Ventilator Associated Pneumonia in Neonates Neonatal Intensive Care Unit Sakon Nakhon Hospital
Article Sidebar
Main Article Content
Abstract
This quasi-experimental research was to study the effect of clinical nursing practice guidelines on the prevention of ventilator associated pneumonia in newborns by 1) studying the practice of professional nurses; 2) comparing the incidence of ventilator-associated pneumonia; 3) studying the satisfaction of professional nurses after using the clinical nursing practice guideline. The sample consisted of 16 professional nurses working in the neonatal intensive care unit and 30 neonates using mechanical ventilation at the neonatal intensive care unit, divided into groups that use the old guidelines and those that use new nursing practice guidelines. Each group consisted of 15 people. Research measurements were a clinical nursing practice guideline for the prevention of ventilator-associated pneumonia in newborns that researchers developed using empirical evidence. The measurements used to collect data consisted of a general record for registered nurses, and neonates using mechanical ventilation appraisal, the measurement for compliance with guidelines, and a satisfaction assessment form after using the guideline. The data were analyzed by 1) analyzing the personal information of the 2 sample group, and analyzing the data using nursing practice guidelines of professional nurses by frequency and percentage. Comparing personal information data of neonatal between groups using the old guideline and the new nursing developed guideline by Chi-square test and independent t-test. Analysis of the satisfaction of professional nurses after using the nursing guideline was measured by using percentage, mean, and standard deviation.
The results were as follow: 1) Professional nurses caring for ventilated newborns followed the newly developed clinical nursing practice guidelines for the prevention of ventilator associated pneumonia in newborns. The overall application of the developed nursing practice guideline was at a high level (87.72%), same as with the aspiration prevention (100%), primary care to prevent infection (92.18%), cleaning and disinfection of ventilators and equipment (90.62%), care of ventilators and equipment (87.62%), patient care to prevent infection (80%). However, the scores of weaning of ventilators was at a moderate level (78.12%). 2) For the newborns who are nursing according to the developed nursing practice guidelines, the incidence of ventilator associated pneumonia (Mean = 9.53, SD = 0.83) was lower than the group using the old guideline (Mean = 21.27, SD = 1.29) with a statistical significance level of .05 and 3) After using the professional nursing practice guidelines, satisfaction in all aspects was at the highest level (Mean = 4.64, SD = 0.48).
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Unrit K. Factors associated with ventilator - associated pneumonia in pediatric intensive care unit Mahasarakham hospital. Journal Mahasarakham Hospital 2020;17(3):13-25. (in Thai).
Lee PL, Lee WT, Chen HL. Ventilator-associated pneumonia in low birth weight neonates at a neonatal intensive care unit: a retrospective observational study. Pediatric Neonatal 2017;58(4):16-21
Kongwong W. Development of preventive measures of pneumonia associated with using ventilator in newborn infants at Phra Nakhon Si Ayutthaya hospital. Journal of the Association of Preventive Medicine of Thailand 2014;5(3):213-23. (in Thai).
Pantian L. Evidence-based practice formation in patient care to prevent pneumonia from using a ventilator in newborn patients. Journal of TUH Journal online 2020;5(3):45-53. (in Thai).
Naudom L, Klompanya T, Chandrakachorn W, T, Pratumnu W, Pantawas M. The development of clinical nursing practice guideline for preventing ventilator-associated pneumonia in neonates. Journal of Nursing Science & Health 2018;42(2):35-43. (in Thai).
Karuno J, Punthmatharith B, Wiroonpanic W. Development of nursing standard for prevention of ventilator associated pneumonia in newborns. Journal of Nursing Songklanagarind Journal 2017;37(1):105-16. (in Thai).
Kamolabutra M, Khamlamloed A. Developing nursing practice guidelines for ventilator Associated pneumonia prevention in neonates at Samutsakhon hospital. Journal of Medical Hospital Sisaket, Surin, Buriram 2014;28(1):53-68. (in Thai).
American Association for Respiratory Care (AARC). Clinical practice guideline. Endotracheal suctioning of mechanically ventilated patients with artificial airways. Respiratory Care 2018;55(6):758-64.
Center for Disease Control and Prevention. Pneumonia (ventilator- associated [VAP] and non-ventilator- associated pneumonia [PNEU]) Event. [Internet]. [cited 2022 June 10] Available from: https://www.cdc.gov/nhsn.
Bertalanffy LV. Toward a system theory of organization. Seaside, CA: Inter-systems Publication; 1998.
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer Health / Lippincott Williams & Wilkins; 2012.
Kamsawang N, Tuandoung P, Atthachit K, Boonsan S. Outcomes of ventilator associated pneumonia (VAP) prevention developed VAP bundle care. Buddhachinaraj Medical Journal 2018;35(1):31-9. (in Thai).
Watcharanat P, Namvongprom A, Pakdevong N. The effectiveness of nursing care protocol on ventilator associated- pneumonia in patients with mechanical ventilator. Kuakarun Journal of Nursing 2015;22(1):144-55. (in Thai).
Kheiawsawang M, Sopaporm O, Siripitayakunkit A, Sutherasan Y. The effects of nursing practice guidelines to prevent ventilator associated pneumonia (VAP) in medical intensive care unit Ramathibodi hospital. Journal of Mahidol R2R 2019;7(1):98-109. (in Thai).
Ritklar L, Saiphoklang K. 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. Journal of Nursing 2015;42(3):95-104. (in Thai).
Aramrom Y. Evidence-Based Practices In Prevention of the Ventilator-Associated Pneumonia (VAP). The Southern College Network Journal of Nursing and Public Health 2015;2(3):144-58. (in Thai).
Rujeerapaiboon N. Risk factors and outcomes of ventilator-associated pneumonia in neonates. Journal of Med 2019;33(2):233-42. (in Thai).
Thamcharoentrakul B, Saensom D. Effects of using nursing practice guideline for ventilator associated pneumonia prevention: medical department. Journal of Baromarajonani College of Nusing, Nakhonratchasima 2018;35(1):25-42. (in Thai).
Assawapalanggool S, Surimuang M. Effectiveness of coaching on adherence towards guidelines for prevention of ventilator-associated pneumonia and clinical outcomes. Ramathibodi Nursing Journal 2020;2(26):138-54. (in Thai).