Impact of education on ventilator-associated pneumonia in the intensive care unit

Subramanian P, Choy KL, Gobal SV, Mansor M, Ng KH
Correspondence: Dr Pathmawathi Subramanian, pathmawathi@um.edu.my

ABSTRACT
Introduction Ventilator-associated pneumonia (VAP) is a common risk among critically ill ventilated patients. This study aimed to investigate the effects of nurse-led education on: (a) knowledge of and compliance with ventilator care bundle (VCB) practices among intensive care unit (ICU) nurses; and (b) reduction in the rates of VAP post intervention.
Methods A quasi-experimental design with pretest-posttest evaluation and observation was used to investigate nurses’ knowledge of and compliance with VCB practices, and the incidence of VAP. The study was conducted among 71 nurses, and the intervention involved structured education on VAP and its prevention using VCB in an ICU setting. Data were analysed using descriptive and inferential statistics.
Results Nurse-led education significantly increased nurses’ knowledge of (t[70] = −36.19; p < 0.001) and compliance with (t[65] = −21.41; p < 0.001) VCB practices. The incidence of VAP, which was 39 per 1,000 ventilator days during the two-month period before intervention, dropped to 15 per 1,000 ventilator days during the two-month period following intervention.
Conclusion Our findings show that nurse-led education on VAP and VCB significantly increased knowledge of and compliance with VCB practices among ICU nurses, and was associated with a reduction in the incidence of VAP among intubated and mechanically ventilated ICU patients. Inclusion of recent knowledge and evidence-based VCB guidelines for VAP prevention when educating anaesthetists, nurses, physiotherapists and other healthcare providers in the critical care setting is recommended.

Keywords: compliance, intensive care, knowledge, ventilator-associated pneumonia, ventilator care bundle
Singapore Med J 2013; 54(5): 281-284; http://dx.doi.org/10.11622/smedj.2013109

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