Critical Care Nurses' Knowledge and Compliance with Ventilator Associated Pneumonia Bundle at Cairo University Hospitals

Abstract

Ventilator-associated pneumonia (VAP) continues to be a common and potentially fatal complication of ventilator care and often encountered within intensive care units (ICUs). Ventilated and intubated patients present critical care nurses the unique challenge to incorporate evidence-based practices surrounding the delivery of high-quality care. Bundled practices approach is composed of individual preventive measures for preventing the incidence and prevalence of VAP and improving outcomes of patients. The aim of this study is to assess the critical care nurses' knowledge and compliance with ventilator associated pneumonia bundle. A descriptive exploratory study design was utilized. A sample of convenience of 45 critical care nurses was recruited from different critical care units at Cairo university hospital for this study. Data were collected between March 2010 and September 2011. The participants initially, were instructed to complete a demographic data sheet and a validated 20- items questionnaire; 15 items multiple-choice and 5 true/ false items covered the knowledge about pathophysiology , risk factors and preventive VAP bundle practices. Then, direct observation of nurses who provided nursing care to mechanically ventilated patients was carried out utilizing VAP bundle compliance checklist that consisted of ventilator bundled practices for preventing VAP. The main bundle items were infection control measures, patient positioning, endotracheal suctioning care, peptic ulcer prophylaxis, oral care, weaning & extubatoin trials ,and ventilator care measures .The results of 20- items questionnaire revealed unsatisfactory knowledge scores (mean= 7.46 + 2.37) and most of the nurses were not compliant with ventilator associated pneumonia bundle practices (average mean = 8.62 + 7.9 out of 29) and there is no specific protocol to follow for VAP prevention. The findings of the study recommended the need for developing and implementing a protocol for VAP prevention in ICUs. Moreover, there is also a need for training programs for nurses on infection control and VAP bundle preventive measures to lessen the prevalence of ventilator associated pneumonia.

Key Words: Critical care nurses' knowledge, compliance, ventilator associated pneumonia bundle