Compliance of ventilator associated pneumonia care bundle by staff nurses in critical care units

Abstract

INTRODUCTION: Ventilator-associated pneumonia (VAP) is a type of hospital-acquired pneumonia that occurs in patients who are mechanically ventilated for more than 48 hours. VAP is the leading cause of nosocomial infections in patients in intensive care units (ICUs). The pathogenesis of VAP originates from microbial pathogens that are aspirated through the tracheal tube cuff and into the lower respiratory tract. Subsequent colonization and overwhelming of the host's mechanical, body fluids, and cellular defense mechanisms leads to the development of VAP.  Objectives:1. To assess the compliance on VAP care Bundle by staff nurses in critical care units.2. To identify the reason for the non-compliance on VAP care bundle.3.To associate the level of compliance on VAP care bundle with demographic variables. Material and Methods: A Descriptive study conducted in critical care units at a tertiary teaching hospital at Puducherry. Institutional review board permission was obtained. The data collection period was one month in the year 2018. The population was nurses who are taking care of mechanical ventilator patients. Samples were selected by census method. The sample size was 50. After getting group consent (verbal consent) from each staff nurses, they were observed by using observational checklist to assess the compliance of VAP care bundle in critical care units. After continuous 3 observations, the participant information sheet was provided and written consent was obtained from each staff nurses. After that the data related to demographic variables and self administered questionnaires on compliance of VAP care bundle was administered over a period of 20 minutes for every participant. Results: In the present study majority 76% (38) staff nurses had average level of compliance to VAP care bundle, 72% (36) of the staff nurses belongs to the age group of 22-25 years,86% (43) of them were females ,96% (48) had completed BSc Nursing,46% (23) of them had 13-36 months of working experience and 58%(29)  had not attended CNE regarding VAP care bundle. Conclusion: The present study assessed the level of compliance of VAP care bundle by staff nurses in critical care units. The practices were observed by using observational checklist and the reasons for non compliance to VAP care bundle given by staff nurses were expensive equipment, lack of awareness and dependence on doctor’s order. The study concludes that the level of compliance among majority of staff nurses were average, so there is need for improvement in nurses performance in implementing VAP care bundle protocol in critical care units.