A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-12-05 DOI:10.1016/j.infpip.2024.100423

Sunil Kumar Bijarania , Rupinder Kaur , Manisha Biswal , Sangeeta Maheshwar , Rajarajan Ganesan , Goverdhan D. Puri , Sushant Konar , Shyam Thingnam

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Abstract

Background

Infection prevention and control (IPC) practices by critical care nurses are crucial in preventing ventilator-associated pneumonia (VAP) and central-line-associated bloodstream infection (CLABSI).

Aim

To implement an integrative approach to developing a set of IPC practices and disseminating information on the IPC practices through an educational multimedia tool to improve compliance with the practices.

Methods

This participatory interventional before–after study was conducted in a single tertiary care centre's cardiac surgical intensive care unit (ICU) from May 2022 to March 2023. Thirty-seven nursing IPC practices related to VAP and eight for CLABSI were finalized through a three-step process: systematized review, focused group discussions (five rounds), and Delphi rounds (three rounds). The IPC practices were disseminated through a multimedia tool, displayed continuously in the ICU. Nurses' compliance with the IPC practices observed directly was compared before and after implementing the multimedia tool.

Results

A total of 6043 observations for practices related to VAP and 1957 observations for those of CLABSI were performed. There was an increase in compliance post implementation for 11 IPC practices related to VAP and two IPC for those of CLABSI. There was an increase in compliance with practices relevant to chlorhexidine baths, oral care, cuff pressure maintenance, hypertonic saline nebulization, endotracheal suctioning, scrubbing the hub for central line access, and assessment of the central line for removal.

Conclusion

Through a participatory approach, we developed a set of IPC nursing practices for VAP and CLABSI. Implementing a multimedia tool, which encompasses the newly implemented IPC practices, improved compliance with many practices.

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重症监护病房感染预防和控制实践的多媒体工具：参与性介入前后研究。

背景：重症监护护士的感染预防和控制（IPC）实践对于预防呼吸机相关性肺炎（VAP）和中央静脉相关血流感染（CLABSI）至关重要。目的：实施一种综合方法来开发一套IPC实践，并通过教育多媒体工具传播有关IPC实践的信息，以提高对实践的遵守。方法：这项参与式介入前后研究于2022年5月至2023年3月在单一三级保健中心的心脏外科重症监护病房（ICU）进行。37项与VAP相关的护理IPC实践和8项与CLABSI相关的护理IPC实践通过三步过程最终确定：系统化审查、重点小组讨论（5轮）和德尔菲（3轮）。IPC实践通过多媒体工具传播，在ICU中持续展示。比较使用多媒体工具前后直接观察到的护士对IPC操作的遵守情况。结果：VAP相关实践共6043次，CLABSI相关实践共1957次。实施后，与VAP相关的11项IPC实践和与CLABSI相关的2项IPC实践的合规性有所增加。对洗必泰浴、口腔护理、袖带压力维持、高渗盐水雾化、气管内吸引、擦洗中心静脉导管、评估中心静脉导管是否摘除的依从性有所增加。结论：通过参与式方法，我们开发了一套针对VAP和CLABSI的IPC护理实践。实现包含新实现的IPC实践的多媒体工具，提高了许多实践的遵从性。

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