Effect of Care Bundle Strategies on Nurses' Performance Regarding Prevention of Ventilator Associated Pneumonia at Neonatal Intensive Care Units

Abstract

Background: Ventilator-Associated Pneumoniais considered a severe health care-associated infection that results in severe morbidity and increase mortality rate. Moreover, it also lengthens hospital staying and increase hospital expenses. The study aims to evaluate the effect of care bundle strategies on nurses' performance regarding prevention of ventilator associated pneumonia at neonatal intensive care Units. Design: Quasi-experimental, pre-and post-intervention study. Subjects: All nurses(65) in neonatal intensive care units at 10 th of Ramadan Charity Hospital and Aga Central Hospital. Tools: Two tools were used; 1 st tool; sociodemographic data and predesigned questionnaire for nurses' knowledge and 2 nd tool; observational checklist to assess nurses' performance regarding ventilator-associated pneumonia. Results: shows a significant improvement of nurses' knowledge regarding ventilator-associated pneumonia care bundle immediately after and at follow up in relation to neonates' positioning, oral care and ventilator care measures and the majority of them had a competent level of performance regarding observed ventilator-associated pneumonia care bundle before, immediately after and three months after program application. Conclusion:The application of care bundle strategies for the nurses had improved their level of knowledge and performance regarding prevention of ventilator-associated pneumonia with highly significant difference between mean score of total nurses' knowledge and performance.Recommendations: Continuous up to date guided protocols should focus on enhancing nurses' performance regarding ventilator-associated pneumonia care bundle.

Assessment of Nurses' Knowledge and Practice Regarding Prevention of Ventilator Associated Pneumonia In Neonates

“…This may be due to no supervision and no role models which may lead to absence of adherence to VAP prevention guidelines. Additionally, lack of training that is appreciated by the fact that a high percentage of the studied nurses did not participate in any training courses regarding VAP prevention.These findings are in line withAmin et al (2021), who discovered that the majority of nursing staff were incompetent prior to the training program as opposed to the minority following it. Nearly one-fifth of them were proficient before to the training program, and the majority were competent right away.…”

“…This might be due to nurse concern that neonates admitted to NICU had low immunity, making them highly susceptible to any infection as VAP. The current study result was supported by Amin, Samra, and Lawend (2021) whose found in their study that, there were significant improvement in knowledge about risk factors of VAP through all program phases. On contrary with Mahfoz, El Sayed, and Ahmed (2022), who found that half of the studied nurses replied the correct answer regarding risk factors of VAP.…”

Optimizing ventilatory support in ARDS: A comprehensive guide for ICU nurses on patient care

“…Implementing a care bundle for the prevention of Ventilatorassociated pneumonia (VAP), which typically develops more than 48 hours after the initiation of mechanical ventilation, is a proven strategy. [59][60][61] This bundle includes six critical elements, each to be evaluated daily. 62 Head-of-Bed Elevation: Elevate the head of the bed to 30-45 • to reduce aspiration risk, except when contraindicated.…”