Preventing Ventilator-Associated Pneumonia (VAP) in a Pediatric Intensive Care Unit using a Modified Ventilator-Associated Pneumonia Bundle: Pre-interventional and Post-interventional Trial

Obeid, Alaa; Kamel, Raymond; Naous, Amal; Merhi, Bassem Abou; Rajab, M. M.

doi:10.5455/ijmr.20140723095601

Cited by 4 publications

(8 citation statements)

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“…Despite statistical insignificance, clinically, this study suggests a positive influence of VAP education and compliance auditing with feedback undertaken in unit. The relationship between preventative strategies and the reduction of VAP rates has been previously seen in PICUs where similar approaches have been implemented (Bigham et al, 2009;Brierley et al, 2012;De Cristofano et al, 2016;Gupta et al, 2014;Obeid et al, 2014).…”

Section: Discussion Of Demographic and Outcome Variables Of The Prospmentioning

confidence: 76%

“…These studies have been repeatedly used by other researchers as the benchmark for VAP preventative strategies in children. Another three studies, Gupta et al (2014), Obeid et al (2014), and De Cristofano et al 2016, are more recent and strengthen the evidence on VAP prevention and education delivery. These studies are consistent with the current medium of information delivery (e-learning) and may encourage staff engagement with VAP education (Labeau et al, 2016;Reime, Harris, Aksnes, & Mikkelsen, 2008).…”

Section: Vap Educationmentioning

confidence: 87%

“…Some studies have recommended incorporation of hand hygiene into the ventilator bundle (Bouadma, Mourvillier, Deiler, Le Corre, et al, 2010;Tolentino-DelosReyes, Ruppert, & Shiao, 2007). In paediatric and neonatal settings, hand hygiene becomes instrumental in the prevention of infection (Azab et al, 2015;Obeid et al, 2014), as children's immature host defence makes them more susceptible to infection compared to adults (Chhapola & Brar, 2015). For instance, two paediatric pre-post implementation study designs incorporating hand hygiene into their ventilator bundle by Bigham et al, (2009) and multicentred study by Rosenthal, Alvarez-Moreno, et al (2012) In PICU, hand hygiene is identified as a key target for quality improvement efforts (Harris et al, 2011).…”

Section: Hand Hygienementioning

confidence: 99%

“…This is due to the significant challenge in maintaining the correct position in small children, particularly if lightly sedated (Foglia et al, 2007). Paediatric studies suggest that the HOB should be kept at a minimum of 15-45 degrees (Bigham et al, 2009;Brierley et al, 2012;De Cristofano et al, 2016;Obeid et al, 2014;Rosenthal, Alvarez-Moreno, et al, 2012).…”

Section: Head Of the Bed (Hob) Elevationmentioning

confidence: 99%

“…Implementation of VAP preventative strategies that addressed staff education and compliance monitoring with feedback have previously resulted in the reduction of VAP rates significantly, from 52% to 6% in a pre-and post-intervention study (Obeid et al, 2014). Kunzmann, Dimitriades, Morrow, and Argent (2016) also achieved a VAP reduction, from 55 per 1000 to 19.1 per 1000 ventilator days over the first five months of their study, with greater reductions achieved down to 4 per 1000 ventilator days with an improvement of VAP preventative strategies compliance from 57% to 83%.…”

Section: The Role Of Vap Education Compliance Auditing With Feedbackmentioning

confidence: 99%

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An epidemiological study of ventilator-associated pneumonia (VAP) and ventilator-associated events (VAE) surveillance and preventative strategies in critically ill children

Ali¹,

Azizah²

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Background: Ventilator-associated pneumonia (VAP) is an ongoing iatrogenic burden within the healthcare system for both adults and paediatrics. Debate continues over the appropriateness of the VAP surveillance tool in paediatrics. Implementation of the new ventilator-associated events (VAE) surveillance tool in the adult setting have shown to overcome the subjectivity of the traditional pneumonia 1 VAP (PNU1/VAP) surveillance tool. Unlike in adult units, the application of the VAE surveillance tool in paediatrics has not been mandated, leaving a question as to its potential application. The lack of VAP paediatric specific studies has hampered progress informing compliance with VAP preventative strategies in paediatric intensive care units (PICUs). Despite good hand hygiene practise being established as a vital infection control measure, perception of 'Speaking up for hand hygiene' in PICU still under-research. Hence, it became a potential area to improve good hygiene practice. Aim: To determine the VAP and VAE incidence using two surveillance tools at two time points; at baseline and post an education campaign aimed at both PICU staff and parents. In addition to testing the two surveillance tools, compliance auditing and staff and parental perspectives of VAP/VAE and preventative strategies was established. Methods: Retrospective study: PNU1/VAP and VAE surveillance tools were applied to 262 mechanical episodes of 234 children who received invasive mechanical ventilation ≥48 hours in PICU in 2015. The sensitivity and specificity of VAE surveillance tool was tested. Other epidemiological data were recorded; demographic characteristics, risk factors and VAP preventative strategies documented within the unit. VAP education, VAP compliance auditing with feedback and surveys: reinforcement of updated VAP education was launched for PICU staff, and a pamphlet focusing on 'Speaking up for hand hygiene' was developed primarily to educate parents. The information was delivered to parents (N=37) via a pamphlet and face-to-face education. VAP compliance auditing was conducted for a two-month period and involved 37 patients in PICU undergoing VAP preventative strategies implemented by PICU staff and parents: hand hygiene, oral hygiene, endotracheal tube (ETT) suctioning, ETT cuff pressure checks, head of bed elevation, ventilator circuit checks, and early enteral feeding commencement. The parents' and nurses' perceptions of 'Speaking up for hand hygiene' were examined through surveys undertaken by 19 parents and 34 nurses. ii Prospective study: a six-month prospective study was conducted to investigate any improvement in incidence rates of VAP/VAE and estimate the compliance rate of VAP preventative strategies. Results: The incidence rate of VAP/VAE was 9.3 per 1000 ventilator days (VAP/VAE) based on end of ventilation and 10.2 (VAP) and 10.4 (VAE) per 1000 ventilator days based on when the patients were no longer at risk. The specificity of the new VAE surveillance tool was high with a slight agreement between the tools. The...

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Section: Discussion Of Demographic and Outcome Variables Of The Prospmentioning

confidence: 76%

Section: Vap Educationmentioning

confidence: 87%

Section: Hand Hygienementioning

confidence: 99%

Section: Head Of the Bed (Hob) Elevationmentioning

confidence: 99%

Section: The Role Of Vap Education Compliance Auditing With Feedbackmentioning

confidence: 99%

See 3 more Smart Citations

An epidemiological study of ventilator-associated pneumonia (VAP) and ventilator-associated events (VAE) surveillance and preventative strategies in critically ill children

Ali¹,

Azizah²

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

Amin

Samra

Lawend

2021

Tanta Scientific Nursing Journal

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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.

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Educating parents on ‘Speaking up for hand hygiene’ in PICU: Perceptions and barriers

Mohd Ali,

Jauncey,

Ballard

et al. 2021

Int J Care Scholars

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Background: Hand hygiene is fundamental approach to prevent and control spread of infection. Many measures available to enhance compliance to hand hygiene, yet little is known of ‘speaking up for hand hygiene’ initiative among parents and nurses especially in paediatric intensive care unit (PICU). Aim: To assess parents’ and nurses’ perceptions on ‘speaking up for hand hygiene’ in the prevention of ventilator-associated pneumonia (VAP) in a PICU. Methods: We revised evidence-based information related to VAP preventative strategies for a PICU population and updated education materials for staff and families using the ‘Speaking up for Hand Hygiene’ initiative. Parents of children receiving mechanical ventilation were provided with education on hand hygiene. Parents and staff groups were invited to participate in a survey exploring their confidence with this initiative. Results: Parents (78.9%) and nurses (91.2%) agreed the initiative would increase hand hygiene practice. Parents (94.5%) would welcome being reminded about hand hygiene but only 68.4% of parents were willing to remind nurses and 78.9% to remind other PICU staff. Nurses (88.2%) reported being willing to remind parents and other PICU staff and 88.2% indicated that they would welcome being reminded about hand hygiene from parents and 94.1% from other PICU staff. Conclusion: Parents of children receiving mechanical ventilation and PICU nursing staff perceived ‘Speaking up for hand hygiene’ as an important initiative. There are, however factors that contribute to a reluctance to prompt hand hygiene that require further research.

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Preventing Ventilator-Associated Pneumonia (VAP) in a Pediatric Intensive Care Unit using a Modified Ventilator-Associated Pneumonia Bundle: Pre-interventional and Post-interventional Trial

Cited by 4 publications

References 0 publications

An epidemiological study of ventilator-associated pneumonia (VAP) and ventilator-associated events (VAE) surveillance and preventative strategies in critically ill children

An epidemiological study of ventilator-associated pneumonia (VAP) and ventilator-associated events (VAE) surveillance and preventative strategies in critically ill children

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

Educating parents on ‘Speaking up for hand hygiene’ in PICU: Perceptions and barriers

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