Preventing Ventilator Associated Pneumonia (VAP): Critical Care Nurses Knowledge of Evidence-Based Practice

Thursday, 10 July 2008: 11:10 AM
Salima Moez Meherali , School of Nursing, The Aga Khan University, Karachi, Pakistan

Learning Objective 1: identify the existing knowledge of critical care nurses’ regarding evidence based practices for the prevention of ventilator associated pneumonia (VAP).

Learning Objective 2: learn the evidence based guidelines for the prevention of ventilator associated pneumonia (VAP).

Background

Ventilator-associated pneumonia (VAP) is the most common infectious complication among patients admitted to intensive care units (ICUs) and accounts for up to more than 50% of all infections among ICU patients in one of the private hospital in Karachi Pakistan. VAP prolongs ICU length of stay and increases the risk of morbidity and mortality in critically ill patients. Nurses' knowledge of evidence based practice help to reduce the risk of ventilator-associated pneumonia.

Method

45 nurses were selected for the study from critical care area. Knowledge was assessed through a self-developed tool, consisting of multiple choice questions (MCQs), based on Centers for Disease Control and Prevention (CDC) guide lines. The difficulty index and discrimination index were calculated and the reliability analysis, to calculate Cronbach's alpha coefficient, was also carried out using SPSS 14.0.

Results

Descriptive statistics of scores for knowledge-test: (n = 45)

Mean 5.8

Median 5.0

Mode 3.0

Standard deviation 2.9

Minimum 3.0

Maximum 7.0

Total score = 10

Nurses in hospitals reported better compliance with hand washing and maintaining head-of-bed elevation, providing regular oral care, but are not familiar with rates of ventilator-associated pneumonia and the organisms involved in this infection.

Conclusion

The guidelines for the prevention of ventilator-associated pneumonia from the CDC are not consistently or uniformly implemented. This study provides an opportunity of continuing education to nurses working in critical care areas, since majority of the nurses working in critical care areas are diploma prepared nurses, no special critical care training only trained through the curriculum provided by the Pakistan Nursing Council (PNC). Although this curriculum has specific objectives and number of hours in critical care nursing, however, it mainly focuses on the disease processes and treatment, not much emphasis is given on the prevention of nosocomial infection.