scholarly journals ASSESSMENT OF KNOWLEDGE AND COMPLIANCE OF CRITICAL CARE NURSES REGARDING VENTILATOR ASSOCIATED PNEUMONIA (VAP) CARE BUNDLE IN A TERTIARY CARE HOSPITAL, ASSAM, INDIA

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Chaltung Khishung Anal
2020 ◽  
Vol 14 (1) ◽  
pp. 7-18
Author(s):  
Samuel Masih ◽  
Khairunnisa Aziz Dhamani ◽  
Sadia Farhan Khan

BackgroundSedation assessment and management is an essential part of critical care nursing. The patients are at significant risks of undersedation and oversedation. Critical care nurses must possess sufficient knowledge about sedation assessment and its management.AimThis study aimed to determine critical care nurses’ knowledge of sedation and its management in mechanically ventilated patients in Pakistan.MethodologyA cross-sectional descriptive study was conducted. The participants were recruited from three critical care units of a tertiary care hospital using a consecutive sampling technique. Data were collected using a self-administered questionnaire.FindingsIn total, 91 critical care nurses participated in this study. Most of them had less than 2 years of experience as registered nurses and as intensive care unit nurses. The majority of them had insufficient knowledge (poor knowledge 18.7% and fair knowledge 63.7%), whereas only 17.6% had good knowledge of sedation and its management. The average correct response rate for general knowledge of sedation management practices was 71.3%. Almost half of the participants (51.6%) had poor knowledge of assessing undersedation and oversedation. Overall, 67% of nurses had good knowledge of managing sedative drugs.ConclusionThe majority of critical nurses lacked sufficient knowledge related to sedation and its management in mechanically ventilated patients. This poses risks to patients’ safety and quality of care.


Author(s):  
Singla Bhavika ◽  
Akshaya N. N.Shetti ◽  
Rachita Mustilwar ◽  
Singla Anshul

Background and aim: Oral care contributes significantly to the patients’ health outcome in a critical care unit. Nurses play a vital role in maintaining good oral health. However, there remains a dearth of literature regarding oral care practices among nurses workingin an Indian critical care unit. In this descriptive cross sectional study, we assessed the level of awareness and the existing practices of patients’ oral care among our critical care unit (CCU) nurses. Methodology: After obtaining approval from the institutional ethics committee, 64 CCU nurses, having work experience of atleast 6 months in the CCU, were enrolled in this descriptive cross sectional study. A self-structured questionnaire was used to assess the awareness and practice of the nurses. The data collected was analyzed using descriptive statistics and results were expressed as percentages.Result: Of the 64 nurses enrolled in the study, there were no dropouts. It was found that 62 (96.87%) nurses provided oral care to all the CCU patients. 60 (93.7%) nurses claimed that a standard oral care protocol has been provided to them. Documentation of the oral care was carried out by 54 (84.37%) nurses. Although 50% of the nurses had been trained to provide oral care, 54 (84.37%) nurses felt the need of fresh training. 60 (93.7%) nurses preferred using toothbrush in conscious patients. Chlorhexidine was the most commonly used solution. Bleeding, extubation and biting were among the few complications that they faced during routine oral care.Conclusion: Despite working in a rural set up with limited resources available, oral care was provided by most of the nurses. Following a standard protocol and documentation of the same, has helped maintain consistency in oral care of all critical care patients.Citation: Bhavika S, Shetti AN, Mustilwar R, Anshul S. Awareness and practice of patient’s oral care among critical care nurses in a rural tertiary care hospital. Anaesth pain & intensive care 2019;23(3):295-300


2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.


Author(s):  
David D. M. Rosario ◽  
Anitha Sequeira

Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.


Author(s):  
Dr. Beena Unnikrishnan ◽  
◽  
Dr. V. Rajendran ◽  
Dr. Mookambika R .V ◽  
Dr. Vishnu G Ashok ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Anne Thushara Matthias ◽  
J. Indrakumar ◽  
Tharushi Ranasinghe ◽  
Shalini Wijekoon ◽  
Charuni Yashodara

The global incidence of sepsis is increasing, and mortality remains high. The mortality is even higher in resource-poor countries where facilities and equipment are limited. The Surviving Sepsis Campaign (SSC) recommends an updated hour-1 bundle based on the evidence from the International Guidelines for Management of Sepsis and Septic Shock 2018. To reduce mortality from sepsis, compliance with the “bundle” is essential. Data from developing countries like Sri Lanka on the management of sepsis according to the SSC guidelines are not available. Hence, this study looks at the patient characteristics and management of septic patients at a tertiary care hospital in Sri Lanka. Patients admitted to the University Medical Unit of Colombo South Teaching Hospital from January to August 2019 fulfilling the inclusion criteria were included. The hour-1 sepsis bundle adherence, demographic data, and management were recorded. There were 387 patients: 163 males and 224 females. The age range was 15-95 with a mean age of 63. 83.7% were direct admissions while 16.3% were transfers from a peripheral hospital. The most common source of infection was urine (82 (21.2%)) followed by blood stream (105 (27.1%)) and skin and soft tissue (114 (29.5%)). One-hour SSC bundle compliance is as follows: administration of intravenous fluids: 42 (10.9%), blood cultures before antibiotics: 225 (58.1%), first dose antibiotic: 15 (3.9%), and arterial blood gas: 60 (15.5%). Staffing capacity did not make a difference to adherence to the bundle. The study mortality rate was 37 (9.6%). Binary logistic regression indicates that quick sequential organ failure assessment (qSOFA) score is a significant predictor of mortality (chi‐square=35.08, df=3, and p=0.001 (<0.05)) with an odds ratio (OR) of 7.529 (95% CI 3.597-14.323). The other predictors, age, sex, adherence to sepsis care bundle, and comorbidities, were not significant. In conclusion, mortality of sepsis is high and adherence to sepsis care bundle is poor in Sri Lanka even at a tertiary care hospital. Education and training of staff are needed to boost adherence. This will in turn improve quality of care and outcomes of septic patients in resource-poor countries.


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