Intensive Care Unit Registered Nurses' Perceived Barriers Towards VAP Prevention in Southeast Iran: An Observational Study

2020 ◽  
Author(s):  
Tayebe Akafzadeh ◽  
Mansoor Arab ◽  
Mahlagha Dehghan ◽  
Alireza Malakoutikhah ◽  
Mansooreh Azizzadeh Forouzi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Registered Nurses ◽  
Organizational Factors ◽  
Perceived Barriers ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Job Experience ◽  
Health Care Associated Infections ◽  
Healthcare Associated

Abstract Background: Health Care-Associated Infections are the most common complications in hospitalized patients. Ventilator-Associated Pneumonia is a subset of Healthcare-Associated Pneumonia. This study aimed to investigate the intensive care unit registered nurses' perceived barriers towards VAP prevention in southeast Iran.Methods: This was a cross-sectional descriptive-analytical study investigating ICU registered nurses in hospitals affiliated to Kerman University of Medical Sciences, Kerman, Iran. The study population consisted of nurses in ICUs and EDs in three hospitals. The sample size was estimated as 242 nurses. The data was collected through a demographic characteristics questionnaire and a researcher-made ventilator-associated pneumonia barriers prevention questionnaire.Results: Nurses’ mean age was 32.9 ± 5.87. 80.2% of the participants were female. The job experience mean score was 9.51 ± 5.14 years. 45% of nurses had received VAP prevention training. The mean score of nurses' perceived barriers towards VAP prevention was 2.82 ± 0.46. The highest mean score of perceived barriers were related to items of "Lack of staff", "Lack of a team-based approach to care and interventions ", and "Lack of support from Management”.Conclusions: According to the present study, most of the barriers mentioned were related to organizational factors such as lack of teamwork. One of the major problems of most Kerman hospitals seems to be the shortage of staff. Further studies are needed in Kerman and other cities of Iran to obtain more accurate results.

scholarly journals Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung

2017 ◽  
Vol 5 (2) ◽  
pp. 85
Author(s):  
M. Fajar Sadli ◽  
Doddy Tavianto ◽  
Ike Sri Redjeki
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Therapy ◽  
Educational Status ◽  
Mean Value ◽  
High Morbidity ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
Vap Bundle

Ventilator associated pneumonia (VAP) merupakan infeksi yang terjadi pada pasien yang terintubasi ≥48 jam di ruang rawat intensif. Penanganan VAP merupakan tantangan utama akibat morbiditas dan mortalitas yang tinggi.Ventilator associated pneumonia bundle (VAPb) telah terbukti dapat menurunkan angka kejadian VAP sehingga pengetahuan dokter dan perawat mengenai VAPb menentukan keberhasilan pencegahan VAP di ruang rawat intensif. Tujuan penelitian ini mengetahui pengetahuan dokter dan perawat mengenai VAPb di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Data diambil dari bulan November–Desember 2016. Penelitian deskriptif dengan desain potong lintang ini menggambarkan pengetahuan mengenai VAPb dari dokter residen Departemen Anestesi dan Terapi Intensif dan perawat di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Responden terdiri atas 79 dokter dan 88 perawat. Tingkat pengetahuan VAPb diuji menggunakan 20 pertanyaan kuesioner. Responden perawat terbanyak berjenis kelamin perempuan (74%), berusia ≥30 tahun (92%), status pendidikan diploma III (65%), lama kerja >5 tahun (76%), dan bekerja di Intensive Care Unit (ICU) (32%). Responden dokter terbanyak berjenis kelamin laki-laki (71%), berusia ≥30 tahun (83%), dan telah menyelesaikan stase ICU (61%). Simpulan, nilai kuesioner perawat dan dokter rata-rata berturut-turut 73,63 dan 73,16. Kata kunci: Klinisi ruang rawat intensif, tingkat pengetahuan, ventilator associated pneumonoia bundle Description of Intensive Care Clinician Knowledge about Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit of  Dr. Hasan Sadikin Hospital BandungVentilator associated pneumonia (VAP) is an infection that occurs in patients who are intubated ≥48 hours in intensive care. Management VAP is a major challenge due to the high morbidity and mortality. Ventilator associated pneumonia bundle (VAPb) has been shown to reduce the incidence of VAP, so knowledge of doctors and nurses about VAPb determine the success of preventing VAP in intensive care. This study aims to know the description of intensive care clinician knowledge about ventilator associated pneumonia bundle in the intensive care of Dr. Hasan Sadikin General Hospital Bandung. Data were collected from November–December 2016. Descriptive study with cross-sectional design depicts VAPb knowledge of resident physicians Department of Anesthesia and Intensive Therapy and nurses in the Intensive Care Department of Dr. Hasan Sadikin Hospital. Respondents consisted of 79 doctors and 88 nurses. The level of knowledge VAPb tested using a 20 question questionnaire. Most nurse respondents were female (74%), aged ≥30 years (92%), educational status diploma III (65%), length of employment >5 years (76%), and work in Intensive Care Unit (ICU) (32%). Most physician respondents were male sex (71%), aged ≥30 years (83%), and had completed stase ICU (61%). In conclution, the mean value of the questionnaire nurses and doctors respectively 73.63 and 73.16. Key words: Intensive care clinician, level of knowledge, ventilator associated pneumonoia bundle

Risk Factors for Ventilator-Associated Pneumonia in Infants and Children: a Cross-sectional Cohort Study

2014 ◽  
Vol 23 (6) ◽  
pp. 469-476 ◽  
Author(s):  
Denise Miyuki Kusahara ◽  
Camila da Cruz Enz ◽  
Ariane Ferreira Machado Avelar ◽  
Maria Angélica Sorgini Peterlini ◽  
Mavilde da Luz Gonçalves Pedreira
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Odds Ratio ◽  
Pediatric Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Vasoactive Drugs ◽  
Cross Sectional

Background The epidemiology of ventilator-associated pneumonia is well described for adults, but little information is available on risk factors for this disease in children. Objective To identify predisposing factors for ventilator-associated pneumonia in children. Methods A cross-sectional prospective cohort study of 96 patients in a 9-bed pediatric intensive care unit was performed. Variables examined were demographic characteristics, inpatient care, medications, nutrition, invasive procedures, and characteristics of mechanical ventilation. Data were analyzed by using Pearson χ2 analysis, Fisher exact and Mann-Whitney tests, odds ratios, and forward stepwise logistic regression. Results Occurrence of ventilator-associated pneumonia correlated positively with use of nasoenteral tubes (odds ratio, 5.278; P < .001), intermittent administration of nutritional formula (odds ratio, 6.632; P = .005), emergency reintubation (odds ratio, 2.700; P = .02), use of vasoactive drugs (odds ratio, 5.108; P = .009), duration of mechanical ventilation (P < .001), and length of stay in the pediatric intensive care unit (P < .001) and in the hospital (P = .01). Conclusion Use of vasoactive drugs, presence of a nasoenteral tube, and duration of stay in the pediatric intensive care unit were independent risk factors for ventilator-associated pneumonia.

scholarly journals Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care unit

2014 ◽  
Vol 23 (3) ◽  
pp. 744-750 ◽  
Author(s):  
Sabrina Guterres da Silva ◽  
Raquel Kuerten de Salles ◽  
Eliane Regina Pereira do Nascimento ◽  
Kátia Cilene Godinho Bertoncello ◽  
Cibele D'Avila Kramer Cavalcanti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cuff Pressure ◽  
Oral Care ◽  
Ventilator Associated Pneumonia ◽  
Endotracheal Suctioning ◽  
Cross Sectional ◽  
Bed Elevation ◽  
Head Of Bed Elevation ◽  
Expected Compliance

We aimed at evaluating compliance with a bundle to prevent ventilator-associated pneumonia in an Intensive Care Unit. It is a quantitative, descriptive and cross-sectional study, conducted in a public hospital in the state of Santa Catarina. Data were collected in July and August of 2012. The sample consisted of 1,146 observations of the four elements that compose the bundle (head of bed elevation between 30-45°; endotracheal suctioning; cuff pressure between 20-30 cmH2O; and oral care with 0.12% chlorhexidine). Expected compliance was equal to a positivity rate ≥80%. Data analysis revealed overall bundle compliance of 794 (69.2%). When analyzed separately, two practices presented expected compliance (84.7%): oral care and suctioning. Head of bed elevation had the lowest compliance (55.5%), followed by cuff pressure (61.8%). We observed the need for strategies that promote the quality of all the elements that compose the bundle in order for its use to be effective.

scholarly journals Nursing actions for the prevention of ventilator-associated pneumonia

2012 ◽  
Vol 25 (spe1) ◽  
pp. 101-107 ◽  
Author(s):  
Fernanda Alves Ferreira Gonçalves ◽  
Virginia Visconde Brasil ◽  
Luana Cássia Miranda Ribeiro ◽  
Anaclara Ferreira Veiga Tipple
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Oral Hygiene ◽  
Ventilator Associated Pneumonia ◽  
Mechanical Ventilator ◽  
Ventilator Circuit ◽  
Cross Sectional ◽  
Nursing Team ◽  
The One

OBJECTIVE: To identify prevention actions of the nursing team related to ventilator-associated pneumonia (VAP). METHOD: A cross-sectional, observational study conducted in an Intensive Care Unit of a teaching hospital in Goiania/GO. RESULTS: Hand hygiene occurred, mainly, after the procedures and most of care, such as elevating the head-of-bed, bronchial and oral hygiene, diet administration, also handlingmechanical ventilator circuits were not adequate and if experienced groups such as the one in the present study are not following the recommendations emerging from evidence, it may indicate that, for some reason, the learning is not being significant. CONCLUSION: Most recommendedmeasures to reduce VAP related to positioning the head-of-bed, bronchial and oral hygiene, administration of diet and handling mechanical ventilator circuit were not followed.

scholarly journals Serum and alveolar procalcitonin had a weak diagnostic value for ventilator-associated pneumonia in patients with pulmonary infection score ≥ 6

2018 ◽  
Vol 56 (1) ◽  
pp. 9-14
Author(s):  
Mehran Shokri ◽  
Roya Ghasemian ◽  
Masomeh Bayani ◽  
Parviz Amri Maleh ◽  
Masoumeh Kamrani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulmonary Infection ◽  
Inflammatory Marker ◽  
Area Under The Curve ◽  
Clinical Pulmonary Infection Score ◽  
Alveolar Type ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Procalcitonin Level

Abstract Background. Measuring the serum and alveolar procalcitonin level as inflammatory marker in the diagnosis of ventilator-associated pneumonia (VAP) has been taken into account. In this study, serum and alveolar procalcitonin levels in patients with suspected VAP and patients with confirmed VAP were compared. Methods. This cross-sectional study was conducted using 50 intubated intensive care unit (ICU) patients, connected to ventilator, from October 2014 to April 2015. 50 patients with clinical pulmonary infection score ≥6 were divided into two groups. Patients whose bronchoalveolar lavage (BAL) has shown the growth of more than 104 CFU/mL were included in confirmed VAP group and other patients were included in suspected VAP group. Serum and alveolar procalcitonin levels were measured and compared between both groups. Results. Mean age of patients was 69.10 ± 42.13 with a range of 16-90 years, out of which 23 patients were male (46%) and 27 patients were female (54%). Moreover, patients’ mean clinical pulmonary infection score was reported to be 7.02 ± 1.07. There was a significant relationship between serum and alveolar procalcitonin in suspected patients and patients with an approved form of pneumonia (p = 0.001 and 0.027). Area under the curve for alveolar procalcitonin was 0.683 (sensitivity = 57%; specificity = 80%) and for serum procalcitonin 0.751 (sensitivity = 71%; specificity = 73%) for the diagnosis of VAP. Conclusion. According to the results of the present study, we can diagnose ventilator-associated pneumonia earlier and more accurately by measuring procalcitonin level (particularly alveolar type) in intensive care unit patients.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

scholarly journals Evaluation of a Continuous Decontamination Technology in an Intensive Care Unit

2020 ◽  
Vol 41 (S1) ◽  
pp. s519-s519
Author(s):  
Tami Inman BSN ◽  
David Chansolme
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urban Hospital ◽  
Patient Room ◽  
Colony Forming Units ◽  
Prevention Interventions ◽  
Continuous Application ◽  
Low Levels ◽  
Healthcare Associated ◽  
Cleaning And Disinfection

Background: The scientific literature increasingly indicates the need for the development of continuous disinfection to address the persistent contamination and recontamination that occurs in the patient rooms despite routine cleaning and disinfection. Methods: To determine a baseline microbial burden level on patient room surfaces in the intensive care unit (ICU) of a large urban hospital, 50 locations were swabbed for total colony-forming units (CFU) and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA). Once the baseline in ICU patient rooms was established, 5 novel decontamination devices were installed in the HVAC ducts near these patient rooms. The devices provide a continuous low-level application of oxidizing molecules, predominately hydrogen peroxide. These molecules exit the duct and circulate in the patient room through normal convection, landing on all surfaces. After activation, environmental sampling was conducted every 4 weeks for 4 months. The effect from continuous low levels of oxidizing molecules on the intrinsic microbial burden and the prevalence of MRSA were analyzed. In addition to external laboratory reports, the facility tracked healthcare-associated infections (HAIs) in the unit. HAI data were averaged by month and were compared to the preactivation average in the same unit. Results: The preactivation average microbial burden found on the 50 locations were 179,000 CFU per 100 in2. The prevalence of MRSA was 71% with an average of 81 CFU per 100 in2. After activation of the devices, levels of microbial burden, prevalence of MRSA, and average monthly HAI rates were all significantly lower on average: 95% reduction in average microbial burden (8,206 CFU per 100 in2); 81% reduction in the prevalence of MRSA (13% vs 71%); 54% reduction in the average of healthcare-onset HAIs. All data were obtained from the averages of sampling data for 4 weeks during the 4-month trial period. Conclusions: The continuous application of low levels of oxidizing molecules throughout the patient rooms of an ICU demonstrated 3 outcomes: reduced overall surface microbial burden, lowered the incidence of MRSA, and significantly decreased the monthly average HAI rate. Please note, the ICU ran other infection prevention interventions at this time, including standard cleaning, as well as and their standard disinfecting techniques.Funding: This study was supported by the CASPR Group.Disclosures: None

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