The development of clinical nursing practice guideline for preventing ventilator-associated pneumonia in Coronavirus disease 2019 patients

Abstract

Objective : To analyze the situation, develop clinical nursing practice guideline, and evaluate the use of clinical nursing practice guideline for preventing ventilator-associated in Coronavirus disease 2019 patients

Methods : This study employed a participatory action research approach. The research participants were 20 professional nurses working at the cohort ward of Maha Sarakham Hospital. The research was divided into three distinct phases: 1) situational analysis, 2) the development of clinical nursing practice guideline, and 3) evaluation of the outcomes. Data collection tools included patient care records for those infected with Coronavirus-2019, forms for recording occurrences of ventilator-associated pneumonia, measurement of knowledge about the use of guidelines, assessments of satisfaction with clinical nursing practice guidelines, and group discussion questions. The study was conducted from April 2022 to March 2023, and data were analyzed using descriptive statistics and content analysis.

Results : 1) During the situational analysis phase, it was observed that patients infected with the 2019 coronavirus who were on ventilators had a relatively high incidence of ventilator-associated pneumonia. This condition led to increased bed occupancy rates, treatment costs, and a higher mortality rate. 2) In the clinical nursing practice development phase, a set of nursing practice guidelines emerged, comprising four activity categories (the 4S Model). These categories included mucus suction and oral hygiene, assessment of weaning from ventilators, prone positioning, monitoring for symptom changes, and maintaining cleanliness and hygiene. 3) In the evaluation phase, it was noted that the incidence of ventilator-associated pneumonia, the duration of intubation, and the mortality rate exhibited a consistent downward trend. Professional nurses demonstrated a high level of knowledge and understanding of the guidelines, with 100% meeting the criteria (80%). Moreover, these nurses diligently followed the guidelines, with over 90% compliance, and expressed a high level of satisfaction with the improved nursing practices, at 92.52%.

Conclusion : The findings of this study highlight the positive impact of the developed clinical nursing practice guideline. This practice not only enhances the delivery of efficient and standardized patient care but also contributes to a reduction in the incidence of ventilator-associated pneumonia, the duration of intubation, and the mortality rate.