Application of a ventilator associated pneumonia prevention guideline and outcomes: A quasi-experimental study

Sousa, Ana Sabrina; Ferrito, Cândida; Paiva, José Artur

doi:10.1016/j.iccn.2018.10.001

Cited by 17 publications

(10 citation statements)

References 23 publications

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“…AEs, such as hospital‐acquired infections, have been shown to decrease when evidence‐based guidelines such as, ventilator‐associated pneumonia prevention guideline, are followed 29‐32 . In addition, the frequencies of infections were found to decrease substantially depending on the design of the ICU and by caring for intensive care patients in single‐patient rooms rather than multibed rooms 33,34 .…”

Section: Introductionmentioning

confidence: 99%

Associations between healthcare environment design and adverse events in intensive care unit

Sundberg

Fridh

Lindahl

et al. 2020

Nursing in Critical Care

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Background Healthcare environment can affect health. Adverse events (AEs) are common because rapid changes in the patients' status can suddenly arise, and have serious consequences, especially in intensive care. The relationship between the design of intensive care units (ICUs) and AEs has not been fully explored. Hence, an intensive care room was refurbished with cyclic lightning, sound absorbents and unique interior, and exterior design to promote health. Aims The aim of this study was to evaluate the differences between a regular and a refurbished intensive care room in risk for AEs among critically ill patients. Design This study retrospectively evaluated associations of AEs and compared the incidence of AEs in patients who were assigned to a multidisciplinary ICU in a refurbished two‐bed patient room with patients in the control rooms between 2011 and 2018. Methods There were 1938 patients included in this study (1382 in control rooms; 556 in the intervention room). Descriptive statistics were used to present the experienced AEs. Binary logistic regressions were conducted to estimate the relationship between the intervention/control rooms and variables concerning AEs. Statistical significance was set at P < 0.05. Results For the frequency of AEs, there were no significant differences between the intervention room and the control rooms (10.6% vs 11%, respectively, P < 0.805). No findings indicated the intervention room (the refurbished room) had a significant influence on decreasing the number of experienced AEs in critically ill patients. Conclusions The findings revealed a low incident of AEs in both the intervention room as well as in the control rooms, lower than previously described. However, our study did not find any decreases in the AEs due to the design of the rooms. Relevance to clinical practice Further research is needed to determine the relationship between the physical environment and AEs in critically ill patients.

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Section: Introductionmentioning

confidence: 99%

Associations between healthcare environment design and adverse events in intensive care unit

Sundberg

Fridh

Lindahl

et al. 2020

Nursing in Critical Care

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“…The exercise given was patients' changing position every 2 hours, i.e., tilt to the left, supine and tilt to the right, different from Sousa et al's (2019) research, which avoided supine position instead of implementing HOB position 30˚-45˚. Thus, the result differed were no significant distinction occurring between mobilization (ambulation) and chest physiotherapy, which was conducted according to the room's routine, with the mobilization and chest physiotherapy followed the SOP (p >0,05), [11]. This result indicates that it requires improvement of mobilization implementation under appropriate SOP with 6 progressive mobilization levels and further research with more significant samples and longer duration.…”

mentioning

confidence: 71%

“…The use of invasive ventilation for a long time can increase the risk of developing VAP, and ICU LOS can lead to an increase [10]. The guidelines of VAP prevention recommendation are continuously developing as in the research done by Sousa et al (2019) in Table 1, [11]. A significant reduction of invasive ventilation use duration was identified through these guidelines, along with the LOS ICU and morbidity rate during the intervention phase and VAP incidents decreased significantly.…”

Section: The Effect Of Progressive Mobilization On Pneumonia Occurrencementioning

confidence: 99%

“…In developing progressive mobilization practices on critical pneumonia patients in Indonesia, many nurses or patients are not encouraged to implement mobilization progressively due to the concerns of the effects on patients' condition, and some hospital institutions have not possessed standard operational procedure for this concept [11]. A similar study discussed the occurrence of ventilator-related pneumonia (VAP) in the intensive care unit as well as the impact of chest mobilization and physical therapy by Hendra & Huraini (2011), with a quasi-experiment comparison design of static group (post-test only control group design), in line with several studies of this review Table 3.…”

mentioning

confidence: 99%

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The Influence of Progressive Mobilization on Pneumonia and Decubitus Occurrences in Critical Patients Using Mechanical Ventilator

Mokorimban¹,

Chayati²

2021

Advances in Health Sciences Research

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Background: The short-term impact felt by critically ill patients and ventilators are Ventilator-Associated Pneumonia (VAP), which is added to the health mechanism due to muscle weakness and the occurrence of pressure sores or decubitus. Prevention of pneumonia in intubation patients is crucial because it can prevent hospital-acquired or nosocomial infections, which is a severe complication. Extensive skin destruction or pressure can cause depression in the blood supply and tissue damage. Decubitus will disturb the blood that enters the depressed (stressed) area and results in tissue death. Physical activity in ICU for critical patients is needed. Progressive mobilization of patients is one of the nurse interventions for patients. Objective: This research aims to identify the effect of progressive mobilization on the formation of pneumonia and (decubitus) in critically ill patients. Method: This research is a literature review accessed from internet database searches named PubMed, Pro-Quest, and Science direct with the keywords mobilization progressive, pneumonia, pressure sores. From the PubMed database, 12473 articles were found, 28986 articles from Pro Quest and Sciencedirect resulted in 51077 articles. After going through the screening process and eligibility, 7 articles fit the inclusion criteria. Results: The stages of progressive mobilization in preventing the risk of pressure sores were developed according to the level of mobility in the Early Mobilization Protocol. Based on the results of a review of 7 articles, mobilization exercises were carried out progressively from Level 1 -Level VI with Head of Bed (HOB) activity 30˚-45˚ until the patient can walk for 2 hours, starting in the first 48 hours after entering critical care and performed every day until 7 to 13-day treatment. Conclusion: This literature review shows that progressive mobilization reduces the incidence of pneumonia in ICU care and the risk of pressure sores. Training for nurses working in critical services is needed to increase knowledge and civilize clinical practices related to progressive mobilization I.

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“…Clinical guidelines produce evidence‐based recommendations that aim to standardize patient care by identifying best practice. Implementation of clinical guidelines into routine practice has the potential to reduce complications, mortality and costs. Despite an increasing trend in clinical guideline production by a variety of bodies, there remains a lack of national or international clinical guidelines designed to meet the needs of patients and health services in low‐ and middle‐income countries (LMICs).…”

Section: Introductionmentioning

confidence: 99%

Delphi prioritization and development of global surgery guidelines for the prevention of surgical-site infection

Adenekan¹,

Cotton²,

Davies³

et al. 2020

British Journal of Surgery

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Background Most clinical guidelines are developed by high‐income country institutions with little consideration given to either the evidence base for interventions in low‐ and middle‐income countries (LMICs), or the specific challenges LMIC health systems may face in implementing recommendations. The aim of this study was to prioritize topics for future global surgery guidelines and then to develop a guideline for the top ranked topic. Methods A Delphi exercise identified and prioritized topics for guideline development. Once the top priority topic had been identified, relevant existing guidelines were identified and their recommendations were extracted. Recommendations were shortlisted if they were supported by at least two separate guidelines. Following two voting rounds, the final recommendations were agreed by an international guideline panel. The final recommendations were stratified by the guideline panel as essential (baseline measures that should be implemented as a priority) or desirable (some hospitals may lack these resources at present, in which case they should plan for future implementation). Results Prevention of surgical‐site infection (SSI) after abdominal surgery was identified as the highest priority topic for guideline development. The international guideline panel reached consensus on nine essential clinical recommendations for prevention of SSI. These included recommendations concerning preoperative body wash, use of prophylactic antibiotics, decontamination of scrub teams' hands, use of antiseptic solutions for surgical site preparation and perioperative supplemental oxygenation. In addition, three desirable clinical recommendations and four recommendations for future research were agreed. Conclusion This process led to the development of a global surgery guideline for the prevention of SSI that is both clinically relevant and implementable in LMICs.

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Application of a ventilator associated pneumonia prevention guideline and outcomes: A quasi-experimental study

Cited by 17 publications

References 23 publications

Associations between healthcare environment design and adverse events in intensive care unit

Associations between healthcare environment design and adverse events in intensive care unit

The Influence of Progressive Mobilization on Pneumonia and Decubitus Occurrences in Critical Patients Using Mechanical Ventilator

Delphi prioritization and development of global surgery guidelines for the prevention of surgical-site infection

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