Evidence-Based Practice: Use of the Ventilator Bundle to Prevent Ventilator-Associated Pneumonia

2007 ◽  
Vol 16 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Arlene F. Tolentino-DelosReyes ◽  
Susan D. Ruppert ◽  
Shyang-Yun Pamela K. Shiao
Keyword(s):  
Oral Care ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Nail Polish ◽  
Before And After ◽  
Coronary Care ◽  
Nurses Knowledge

• 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. • ResultsAfter 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.

scholarly journals Evaluation of critical care nurses’ knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia

2015 ◽  
Vol 2 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Samaneh Shahidi Far ◽  
Amir Emami Zeydi ◽  
Behzad Taghipour ◽  
Hamid Sharif Nia ◽  
Mohammad Ali Soleimani ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Care Nurses ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Evidence Based Guidelines ◽  
Nurses Knowledge

scholarly journals Preventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses

2014 ◽  
Author(s):  
Dana Ferrazzano
Keyword(s):  
Intensive Care ◽  
Emergency Room ◽  
Oral Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Preventative Measures ◽  
Emergency Room Nurses ◽  
Evidence Based Guidelines ◽  
The Impact ◽  
Nurses Knowledge

<p>Ventilator-associated pneumonia (VAP) is the second most common hospital acquired infection and is primarily found in the intensive care units. The presence of an endotracheal tube is the primary risk factor for developing VAP. Many times the process of intubation occurs pre-hospital, in the emergency room (ER) or in the operating room. Ventilator associated pneumonia is associated with increased hospital stay and costs. Evidence-based guidelines have been developed to decrease the occurrence of VAP and decrease patient mortality. Preventative measures are initiated on the intensive care unit once the patient is transferred. The purpose of this study was to evaluate the impact of an educational program on ER nurses knowledge of VAP and preventative measures to decrease VAP.</p> <p>The study took place at Rhode Island Hospital, a level 1 trauma center located in Providence, RI. Participants were ER nurses who worked in the critical care area of the ER. A pre-intervention-posttest design was used to evaluate emergency room nurses knowledge regarding VAP. The intervention consisted of a posterboard and study guide that provided information regarding evidence-based guidelines that could be implemented in the ER such as oral care, and head of bed elevation. The overall results on the pre and posttest demonstrated that ER nurses were unaware that oral care and the use of chlorhexidine were important interventions to reduce the incidence of developing VAP. Recommendations and implications for advanced practice nursing and the need for future research are discussed.</p>

Continuing to Challenge Practice to Be Evidence Based

2015 ◽  
Vol 35 (2) ◽  
pp. 39-50 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Kimmith Jones ◽  
Anna C. Fisk
Keyword(s):  
Critical Care ◽  
Daily Practice ◽  
Medication Administration ◽  
Chest Physiotherapy ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Care Practice ◽  
Evidence Based ◽  
Actual Weight ◽  
Daily Interruption

Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient’s actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice.

The Impact of a Simple, Low-cost Oral Care Protocol on Ventilator-associated Pneumonia Rates in a Surgical Intensive Care Unit

2008 ◽  
Vol 24 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Carrie S. Sona ◽  
Jeanne E. Zack ◽  
Marilyn E. Schallom ◽  
Maryellen McSweeney ◽  
Kathleen McMullen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Cost ◽  
Oral Care ◽  
Surgical Intensive Care Unit ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Care Protocol ◽  
The Impact

Examining the Evidence to Guide Practice: Challenging Practice Habits

2014 ◽  
Vol 34 (2) ◽  
pp. 28-45 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Robin Watson ◽  
Ann Will Poteet
Keyword(s):  
Critical Care ◽  
Current Practice ◽  
American Association ◽  
Daily Practice ◽  
Feeding Tube ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Evidence Based ◽  
Health Care Workforce ◽  
In Infants And Children

Nurses are the largest segment of the nation’s health care workforce, which makes nurses vital to the translation of evidence-based practice as a practice norm. Critical care nurses are in a position to critically appraise and apply best evidence in daily practice to improve patients’ outcomes. It is important for critical care nurses to continually evaluate their current practice to ensure that they are applying the current best evidence rather than practicing on the basis of tradition. This article is based on a presentation at the 2013 National Teaching Institute of the American Association of Critical-Care Nurses. Four practice interventions that are within the realm of nursing are critiqued on the basis of current best evidence: (1) turning critically ill patients, (2) sleep promotion in the intensive care unit, (3) feeding tube management in infants and children, and (4) prevention of venothromboembolism…again. The related beliefs, current evidence, and implications for practice associated with each topic are described.

Sign in / Sign up

Export Citation Format

Share Document