Prevention of Ventilator-Associated Pneumonia: Can Knowledge and Clinical Practice Be Simply Assessed in a Large Institution?

Abstract

OBJECTIVE: User-friendly scores to assess knowledge of guidelines for prevention of ventilatorassociated pneumonia (VAP) are scarce and have mainly evaluated nurses, but not students or physicians. Gaps between knowledge and actual clinical practice have not been sufficiently analyzed. We assessed knowledge of and adherence to guidelines for prevention of VAP among physicians, nurses, and students in adult ICUs. METHODS: All adult ICU healthcare workers were invited to complete a 20-point questionnaire. The first part assessed personal knowledge of international guidelines for prevention of VAP; the second part assessed daily clinical practice. Personal knowledge and daily practice were scored from 0 to 10 points. RESULTS: We invited 257 ICU healthcare workers to participate in the study, and 167 (65%) accepted (32/54 physicians, 108/176 nurses, and 27/27 students). The median (IQR) personal knowledge scores for physicians, nurses, and students were 6 (5-7), 5 (4 -6), and 5 (4 -7), respectively. The median scores for daily clinical practice for physicians and nurses were 5 (4 -6) and 4 (3-5), respectively. Healthcare workers with more than 1 year of ICU experience scored significantly better in personal knowledge than those with less experience: 6 (5-7) versus 4 (3-6), P ‫؍‬ .004. CONCLUSIONS: A simple, easy-to-complete questionnaire enabled us to rapidly evaluate personal knowledge and reported clinical practice in prevention of VAP in large teaching institutions. These scores will be used as baseline figures to assess the impact of educational and intervention campaigns.

A survey on oral care practices for ventilator‐assisted patients in intensive care units in 3A hospitals of mainland China

“…Our 18‐item self‐assessment questionnaire, which we designed based on a review of the literature, proved efficient for rapid evaluation of oral care knowledge and clinical practices for VAP prevention among ICU nurses …”

Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung

“…Hasil ini berdampak pada implementasi rangkaian pencegahan VAP di ruang rawat intensif itu rendah. 15 Cuci tangan merupakan aktivitas yang rutin dilakukan oleh perawat dan dokter sebelum dan setelah kontak dengan pasien. Cuci tangan mencegah kontaminasi silang atau kolonisasi mikroorganisme melalui tangan.…”

“…15 Penerapan prosedur aseptik yang rendah menjadi salah satu faktor risiko infeksi di ruang rawat intensif. Penerapan prosedur aseptik selama suctioning serta cuci tangan sebelum dan sesudah tindakan berhubungan dengan penurunan risiko kontaminasi mikroorganisme.…”

“…15 Aspirasi pada pasien dengan ventilator 16 Rute intubasi, sistem suctioning ETT, dan ekstubasi dini menurunkan risiko VAP. Tekanan cuff ETT harus dipertahankan untuk mencegah sekresi yang terakumulasi di atas cuff masuk atau aspirasi karena refluks cairan gastrointestinal dengan dilakukan gangguan fungsi sfingter gastroesofageal akibat pemasangan pipa nasogatrik atau orogastrik.…”

“…Penelitian di Spanyol tahun 2013 mendeskripsikan bahwa 63,9% perawat dan 78,1% dokter mengetahui perawatan rongga mulut mencegah VAP. 15 Sebanyak 65% perawat dan 57% dokter mengetahui penggunaan profilaksis ulkus peptikum meningkatkan risiko VAP secara tidak langsung melalui peningkatan kepadatan koloni bakteri aerob gastrointestinal. Terapi profilaksis yang diberikan pada pasien VAP adalah antibiotik dan obat dekontaminasi oral (chlorhexidine dan povidone-iodine).…”