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Hamishehkar H, Vahidinezhad M, Mashayekhi SO, et al. Education alone is not enough in ventilator associated pneumonia care bundle compliance. J Res Pharm Pract. 2014;3(2):51-5doi: 10.4103/2279-042X.137070.
Hamishehkar, H., Vahidinezhad, M., Mashayekhi, S. O., Asgharian, P., Hassankhani, H., & Mahmoodpoor, A. (2014). Education alone is not enough in ventilator associated pneumonia care bundle compliance. Journal of research in pharmacy practice, 3(2), 51-5. https://doi.org/10.4103/2279-042X.137070
Hamishehkar, Hadi, et al. "Education alone is not enough in ventilator associated pneumonia care bundle compliance." Journal of research in pharmacy practice vol. 3,2 (2014): 51-5. doi: https://doi.org/10.4103/2279-042X.137070
Hamishehkar H, Vahidinezhad M, Mashayekhi SO, Asgharian P, Hassankhani H, Mahmoodpoor A. Education alone is not enough in ventilator associated pneumonia care bundle compliance. J Res Pharm Pract. 2014 Apr;3(2):51-5. doi: 10.4103/2279-042X.137070. PMID: 25114937; PMCID: PMC4124680.
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J Res Pharm Pract. 2014 Apr;3(2):51-5. doi: 10.4103/2279-042X.137070.

Education alone is not enough in ventilator associated pneumonia care bundle compliance.

Journal of research in pharmacy practice

Hadi Hamishehkar, Mahdi Vahidinezhad, Simin Ozar Mashayekhi, Parina Asgharian, Hadi Hassankhani, Ata Mahmoodpoor

Affiliations

  1. Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  2. Iranian Evidence Based Medicine Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
  3. The Liver and Gastrointestinal Research Center, Tabriz University of Medical sciences, Tabriz, Iran.
  4. Student Research center committee, Tabriz University of Medical Sciences, Tabriz, Iran.
  5. Department of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran.
  6. Department of Anesthesiology and critical care, Tabriz University of Medical Sciences, Tabriz, Iran.

PMID: 25114937 PMCID: PMC4124680 DOI: 10.4103/2279-042X.137070

Abstract

OBJECTIVE: Ventilator-associated pneumonia (VAP) described as a secondary and preventable consequence in mechanically ventilated patients, emerges 48 h or more after patients intubation. Considering the high morbidity and mortality rate of VAP and the fact that VAP is preventable, it seemed necessary to evaluate care bundle compliance rate and effect of education on its improvement.

METHODS: This observational study was conducted on 10 Intensive Care Units (ICUs) of four university affiliated hospitals in three steps. In the first step, VAP care bundle compliance including head of bed (HOB) elevation, endotracheal cuff pressure (ETCP), mouthwash time, utilizing close suction systems, subglottic secretion drainage, type of suction package, and hand wash before suctioning was evaluated. In the second and third steps, ICU staffs were trained and its effect on VAP care bundle compliance was investigated. Finally, an inquiry from nurses was conducted to evaluate the obtained results.

FINDINGS: A total of 552 checklists consisting of 294 observations in the pre-education group and 258 observations in the posteducation group were filled. Mean VAP care bundle compliance in pre-education and posteducation stages was 36.5% and 41.2%, respectively (P > 0.05). Except for patients' mouth washing, there were no improvement in HOB elevation (>30°), hand washing and ETCP after education. Based on the results of questionnaire received from nurses at the end of study, more than 90% of nurses believed that lack of rigid monitoring of VAP care bundle is a main reason of low adherence for VAP care bundle compliance.

CONCLUSION: The adherence to VAP care bundle was inappropriate. Education seems to be ineffective on improving VAP care bundle compliance. Frequent recall of the necessity of the VAP care bundle and the continuous supervision of ICU staffs is highly recommended.

Keywords: Compliance; VAP care bundle; Ventilator-associated pneumonia (VAP); education

References

  1. JAMA. 2007 Apr 11;297(14):1583-93 - PubMed
  2. Aust Crit Care. 1994 Sep;7(3):16-21 - PubMed
  3. Eur Respir J. 2001 May;17(5):1034-45 - PubMed
  4. MMWR Recomm Rep. 2004 Mar 26;53(RR-3):1-36 - PubMed
  5. Curr Opin Infect Dis. 2007 Apr;20(2):190-7 - PubMed
  6. J Crit Care. 2008 Mar;23(1):126-37 - PubMed
  7. Ann Intern Med. 2004 Aug 17;141(4):305-13 - PubMed
  8. Anaesthesia. 1992 Apr;47(4):335-9 - PubMed
  9. Am J Respir Crit Care Med. 1999 Mar;159(3):695-701 - PubMed
  10. Respir Care. 2003 Sep;48(9):869-79 - PubMed
  11. Lancet. 1999 Nov 27;354(9193):1851-8 - PubMed
  12. Intensive Care Med. 2002 Mar;28(3):304-9 - PubMed
  13. Am J Crit Care. 2003 May;12(3):220-30; quiz 231-2 - PubMed
  14. Heart Lung. 1997 Nov-Dec;26(6):419-29 - PubMed
  15. Chest. 2008 Nov;134(5):938-946 - PubMed
  16. Am J Med. 2005 Jan;118(1):11-8 - PubMed

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