Lessons learned from a rapid implementation of a ventilator-associated pneumonia prevention bundle.
Ventilator-associated pneumonia
barriers to translation
care bundle
evidence-based practice
Journal
Journal of infection prevention
ISSN: 1757-1774
Titre abrégé: J Infect Prev
Pays: England
ID NLM: 101469725
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
18
12
2018
accepted:
04
04
2019
entrez:
26
11
2019
pubmed:
26
11
2019
medline:
26
11
2019
Statut:
ppublish
Résumé
Ventilator-associated pneumonia (VAP) is a common avoidable healthcare associated infection in ventilated critical care patients that can have a detrimental impact on patient recovery. To increase uptake at a local level, care bundles should be designed and implemented in collaboration with the end-users who will implement the bundle into practice. The aim in this study was to evaluate critical care nurses' perceptions of the usability of a respiratory care bundle as an effective approach to VAP prevention. An exploratory descriptive qualitative study was conducted. A respiratory care bundle consisting of five components was implemented over a 4-week period. Following implementation, a focus group and semi-structured interviews were conducted to obtain nurses' feedback on the useability of the care bundle. Seven intensive care nurses caring for ventilated patients participated in the study. Participants confirmed that using a care bundle provided a structured approach to nursing care of a ventilated patient and that the use of checklist reminders at the bedside was useful in a busy practice environment. Barriers to uptake and implementation of the bundle were that the unit culture did not prioritise preventative care and the need for a structured interdisciplinary approach to sedation and weaning of mechanical ventilation. To successfully imbed all elements of a respiratory care bundle into practice; an interdisciplinary approach is needed in which there is a strong emphasis on preventative care. These findings highlight the advantages of involving end-users in the development of strategies to decrease VAP.
Sections du résumé
BACKGROUND
BACKGROUND
Ventilator-associated pneumonia (VAP) is a common avoidable healthcare associated infection in ventilated critical care patients that can have a detrimental impact on patient recovery. To increase uptake at a local level, care bundles should be designed and implemented in collaboration with the end-users who will implement the bundle into practice.
AIM/OBJECTIVE
OBJECTIVE
The aim in this study was to evaluate critical care nurses' perceptions of the usability of a respiratory care bundle as an effective approach to VAP prevention.
METHODS
METHODS
An exploratory descriptive qualitative study was conducted. A respiratory care bundle consisting of five components was implemented over a 4-week period. Following implementation, a focus group and semi-structured interviews were conducted to obtain nurses' feedback on the useability of the care bundle. Seven intensive care nurses caring for ventilated patients participated in the study.
FINDINGS/RESULTS
RESULTS
Participants confirmed that using a care bundle provided a structured approach to nursing care of a ventilated patient and that the use of checklist reminders at the bedside was useful in a busy practice environment. Barriers to uptake and implementation of the bundle were that the unit culture did not prioritise preventative care and the need for a structured interdisciplinary approach to sedation and weaning of mechanical ventilation.
DISCUSSION
CONCLUSIONS
To successfully imbed all elements of a respiratory care bundle into practice; an interdisciplinary approach is needed in which there is a strong emphasis on preventative care. These findings highlight the advantages of involving end-users in the development of strategies to decrease VAP.
Identifiants
pubmed: 31762789
doi: 10.1177/1757177419846588
pii: 10.1177_1757177419846588
pmc: PMC6851617
doi:
Types de publication
Journal Article
Langues
eng
Pagination
274-280Informations de copyright
© The Author(s) 2019.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Am J Infect Control. 2016 Oct 1;44(10):e173-e176
pubmed: 27388264
Crit Care Med. 2013 Sep;41(9 Suppl 1):S116-27
pubmed: 23989089
J Infect Prev. 2019 Jan;20(1):5-17
pubmed: 30719083
Am J Epidemiol. 2007 Jun 1;165(11):1321-7
pubmed: 17400571
Intensive Crit Care Nurs. 2014 Apr;30(2):61-8
pubmed: 24314858
Implement Sci. 2015 Aug 15;10:119
pubmed: 26276569
J Hosp Infect. 2019 Mar;101(3):248-256
pubmed: 30036635
Clin Microbiol Infect. 2013 Apr;19(4):363-9
pubmed: 22439889
J Nurs Adm. 2012 Sep;42(9):410-7
pubmed: 22922750
J Intensive Care Soc. 2016 Aug;17(3):238-243
pubmed: 28979497
Am J Infect Control. 2014 Jan;42(1):34-7
pubmed: 24189326
Anesth Analg. 2015 Apr;120(4):837-43
pubmed: 25383717
Aust Crit Care. 2018 Sep;31(5):292-302
pubmed: 29246795
J Nurs Adm. 2017 Jan;47(1):56-61
pubmed: 27926624
Intensive Crit Care Nurs. 2013 Oct;29(5):261-5
pubmed: 23816403
Crit Care Nurse. 2016 Oct;36(5):e1-e7
pubmed: 27694363
Aust Health Rev. 2015 Feb;39(1):37-43
pubmed: 25362241
Infect Control Hosp Epidemiol. 2014 Aug;35(8):915-36
pubmed: 25026607