Effectiveness of Bundle Implementation and Staff Education in Reducing Ventilator-Associated Pneumonia (VAP) in the PICU

2.50
Hdl Handle:
http://hdl.handle.net/10755/157104
Category:
Abstract
Type:
Presentation
Title:
Effectiveness of Bundle Implementation and Staff Education in Reducing Ventilator-Associated Pneumonia (VAP) in the PICU
Author(s):
Geary, Heidi
Author Details:
Heidi Geary, Childrens Hospital Los Angeles, Los Angeles, California, USA, email: hgeary@gmail.com
Abstract:
PURPOSE: The goal of this IRB-approved study was to implement an evidence-based ventilator bundle applicable to the pediatric population and to educate patient care providers in the PICU regarding its use in the prevention of VAP. Evidence suggests that the use of a bundle and an increase in knowledge and awareness about VAP among patient care providers will bring about a change in clinical practice and therefore, decrease VAP rates in the PICU. BACKGROUND: In 2002 the CDC reported the average rate of VAP per 1000 ventilator days ranged from 2.2 to 14.7. Reports have shown that VAP can increase ICU and hospital length of stay, mortality, and total cost of care. In 2004, the 100,000 Lives Campaign developed recommendations for improving patient safety, addressing VAP. Since then, the effectiveness of these recommendations has been well documented in the adult population, but its significance to the pediatric population needs further development. METHODS: Observational audits, which evaluated staff for current practice standards relating to the care of ventilated patients, were completed. A 45-minute VAP education program directed toward all RNs and Respiratory staff in the PICU was implemented. This included the introduction of an evidence-based VAP bundle, consisting of 5 interventions. The program was preceded by a 10-question test to assess for baseline knowledge of VAP. The test was repeated after the education to assess for knowledge gained. Observational audits were then repeated to assess for adherence to the bundle. VAP rates were collected throughout the study and appropriate statistical analysis was applied. RESULTS: Demographics of staff who completed the education was 100% of RN's and 62% of respiratory staff in the PICU. The changes in test scores before and after the education showed an increase in staff knowledge of VAP. The mean score of the pretest and post-test showed a difference of 3.6 (p<0.0001). The score was compiled from the number of correct answers out of 10 questions. When comparing observational audits before and after the education, 2 out of 5 bundle interventions showed a significant increase in compliance by staff (p<0.001 and p<0.002). VAP rate data has shown a downward trend since the initiation of this study and continues to be collected in order to substantiate these findings. CONCLUSIONS: Implementation of an evidence-based ventilator bundle applicable to the pediatric population and education of patient care providers in the PICU regarding its use in the prevention of VAP was successful in decreasing the rate of Ventilator-Associated Pneumonia in the PICU.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleEffectiveness of Bundle Implementation and Staff Education in Reducing Ventilator-Associated Pneumonia (VAP) in the PICUen_GB
dc.contributor.authorGeary, Heidien_GB
dc.author.detailsHeidi Geary, Childrens Hospital Los Angeles, Los Angeles, California, USA, email: hgeary@gmail.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157104-
dc.description.abstractPURPOSE: The goal of this IRB-approved study was to implement an evidence-based ventilator bundle applicable to the pediatric population and to educate patient care providers in the PICU regarding its use in the prevention of VAP. Evidence suggests that the use of a bundle and an increase in knowledge and awareness about VAP among patient care providers will bring about a change in clinical practice and therefore, decrease VAP rates in the PICU. BACKGROUND: In 2002 the CDC reported the average rate of VAP per 1000 ventilator days ranged from 2.2 to 14.7. Reports have shown that VAP can increase ICU and hospital length of stay, mortality, and total cost of care. In 2004, the 100,000 Lives Campaign developed recommendations for improving patient safety, addressing VAP. Since then, the effectiveness of these recommendations has been well documented in the adult population, but its significance to the pediatric population needs further development. METHODS: Observational audits, which evaluated staff for current practice standards relating to the care of ventilated patients, were completed. A 45-minute VAP education program directed toward all RNs and Respiratory staff in the PICU was implemented. This included the introduction of an evidence-based VAP bundle, consisting of 5 interventions. The program was preceded by a 10-question test to assess for baseline knowledge of VAP. The test was repeated after the education to assess for knowledge gained. Observational audits were then repeated to assess for adherence to the bundle. VAP rates were collected throughout the study and appropriate statistical analysis was applied. RESULTS: Demographics of staff who completed the education was 100% of RN's and 62% of respiratory staff in the PICU. The changes in test scores before and after the education showed an increase in staff knowledge of VAP. The mean score of the pretest and post-test showed a difference of 3.6 (p<0.0001). The score was compiled from the number of correct answers out of 10 questions. When comparing observational audits before and after the education, 2 out of 5 bundle interventions showed a significant increase in compliance by staff (p<0.001 and p<0.002). VAP rate data has shown a downward trend since the initiation of this study and continues to be collected in order to substantiate these findings. CONCLUSIONS: Implementation of an evidence-based ventilator bundle applicable to the pediatric population and education of patient care providers in the PICU regarding its use in the prevention of VAP was successful in decreasing the rate of Ventilator-Associated Pneumonia in the PICU.en_GB
dc.date.available2011-10-26T19:25:29Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:25:29Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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