The Development of nursing practice Guidelines for ventilator-associated pneumonia at surgical intensive care unit in Mahasarakham hospital

Abstract

The study was base on the concept of participation action research. The purpose of this study were to develop a model of nursing practice for the prevention of ventilator-associated pneumonia, evaluation by observation of implementation on ICU nurse, practices for the prevention of ventilator-associated pneumonia and the incidence of ventilator-associated pneumonia in surgical intensive care unit and the satisfactory for nurses who worked in the surgical intensive care unit. Action research method was    used consisting of forth phase. The first phase was the situational analysis of VAP and the ICU nurses^, practices for the prevention of ventilator-associated pneumonia. The second phase was development of practice guideline. The third phase was the implementation phase. The forth phase was the evaluation phase. The samples were divided into two groups including 13 nurses who worked in a surgical intensive care unit of Mahasarakham hospital and 245 patients whom admitted into this unit between August 2013 to February 2014. The data were collected through observation and questionnaire. Data were analyzed by descriptive statistics, frequency, percentage and standard deviation.

After the model was implemented, it was found that the incidence of VAP decreased from 20.10 : 1,000 VD to 11.93 : 1,000 VD. The factors contributed to the increasing number were: inadequate knowledge of health personnel, skill, and awareness concerning VAP prevention, practice guideline had unclear standard and non practicable. This study was develop model of nursing practice, promoting clinical practice guidelines by using the educational training, providing feedback, displaying a monitorial poster, and supporting the personal protective ventilator-associated pneumonia equipments, nurse compliance to the clinical practice guideline was higher than before in all activities from 72.90 % to 92.80 %. Finally nurses were satisfied with the model at the high level.