This is a critical skill in the nursing care protocols
Evidence-Based Practice: Use of the Ventilator Bundle to Prevent Ventilator-Associated Pneumonia
By Arlene F. Tolentino-DelosReyes, RN, MSN, acnp, Susan D. Ruppert, RN, PhD, aprn, bc, np-C, Shyang-Yun Pamela K. Shiao, RN, PhD. From the School of Nursing, The University of Texas Health Science Center at Houston, Houston, Tex (AFT-D, SDR), and School of Nursing, University of Houston Victoria and University of Houston System at Sugar Land, Sugar Land, Tex (S-YPKS).
• Purpose To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia.
• Method Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30° to 45°, were observed in 99 intubated patients.
• Results After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P =.009), oral care (P =.009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P <.001), and limiting the wearing of rings (P <.001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P = .38).
• Conclusion Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice. (American Journal of Critical Care. 2007;16:20-27)
Summary
Name:
Institution:
The research paper is trying to establish how well the nurses know and understand the use of the ventilator bundle in preventing pneumonia. This is a critical skill in the nursing care protocols, given that it is a safety measure. The Ventilator-Associated Pneumonia is crucial to the patients that are receiving the mechanical ventilation and those that are critically ill. According to the American association of critical care nurses (AACN), there are a series of steps that a nurse ought to follow to make sure that the procedure is successful, referred to as the ventilator bundle, which incorporates some of the guidelines from the Center of Disease Control and prevention. These include; head elevation at 30 degrees, removal of the subglottic secretions, ventilator circuit change every 48 hours and washing the hands every time before and after the contact with the patient.
The methodology involved a power point presentation a pretests and a posttest. There were a total of 8 sessions that were conducted within two units. The nurses would go through the VAP prevention test within the coronary care unit (CCU) and then in the surgical unit ICU (SICU) within a large hospital. The tests consisted of ten items on the prevention and the interventions of the VAP that are based on the ven...