There have been many studies that have looked at the effects of the bundled interventions on preventing VAP’s in ICU’s. The interventions have evolved over time and have been studied by various specialties (MD, RN, RRT). Nurses are typically involved in the development and implementation of these interventions, and they are the front line providers of the elements of the bundle. This process is driven by nursing accountability and a tremendous amount of responsibility to ensure that outcomes are positive. The ICU staff agreed that this success is related to following evidenced based protocols consisting of a VAP bundle. The multidisciplinary team included ICU Intensivists, ICU staff nurses, a Clinical Nurse Educator, respiratory therapists, dieticians, social workers and pharmacists. In the past, the ICU has gone through many changes related to interventions, equipment, products and staffing turn-over. In spite of this, the ICU has remained VAP free. This is the first study of its kind that has examined from a qualitative approach what the RN’s perception of influence on creating and sustaining a VAP free culture.
The aim of this study is to examine the perception of all RN’s in a community based ICU related to a VAP free culture
Methods: This study was a qualitative study that utilized a Grounded Theory Approach. Seven focus groups were conducted and recorded over a period of one month. IRB approval and informed consent was obtained from the participants prior to the study. The recordings were transcribed and the research team analyzed the data for themes. The main themes identified were: product influence, in particular “mouth care kits,” bundles, multidisciplinary team collaboration, staff education, performance improvement and quality indicators, professional development, and patient/family education. These themes were identified with the RWJUH Practice Model.
Results: Transcript analysis was completed and the following themes were identified: Products (oral care kits), use of EBP VAP prevention bundles, education (pt, family, staff), multidisciplinary collaboration, PI collection and Professional development.
Conclusion: The ICU attributed their success to consistent evidenced-based practice, ongoing education and professional accountability. Further qualitative studies are needed to examine nurses, who are at the front line of healthcare, and their perceptions towards sustainability of initiatives.