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Lessons learned from a rapid implementation of a ventilator-associated pneumonia prevention bundle
Elyse Ladbrook1,2, Stéphane L Bouchoucha1,2,3, Ana Hutchinson1,2,3
1Deakin University, Geelong, Australia.
Journal of Infection Prevention
|November 26, 2019
Summary
Critical care nurses found respiratory care bundles structured nursing care for ventilated patients. However, unit culture and interdisciplinary approaches were barriers to preventing ventilator-associated pneumonia (VAP).
Area of Science:
- Healthcare quality improvement
- Infection prevention and control
- Critical care nursing
Background:
- Ventilator-associated pneumonia (VAP) is a significant healthcare-associated infection in critical care.
- VAP negatively impacts patient recovery and increases healthcare costs.
- Effective VAP prevention strategies require end-user involvement in design and implementation.
Purpose of the Study:
- To assess critical care nurses' perceptions of a respiratory care bundle's usability for VAP prevention.
- To identify facilitators and barriers to implementing a VAP prevention bundle in practice.
Main Methods:
- An exploratory descriptive qualitative study design was employed.
- A five-component respiratory care bundle was implemented over four weeks.
- Focus groups and semi-structured interviews were conducted with seven intensive care nurses.
Main Results:
- Nurses perceived the care bundle as providing a structured approach to patient care.
- Checklist reminders were found useful in a fast-paced clinical setting.
- Barriers included a unit culture not prioritizing preventative care and the need for interdisciplinary collaboration on sedation and ventilation weaning.
Conclusions:
- Successful integration of respiratory care bundles requires an interdisciplinary approach emphasizing preventative care.
- Involving end-users in developing VAP reduction strategies is crucial for effective implementation.
- Addressing cultural and systemic barriers is essential for optimizing VAP prevention bundles.
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