Effectiveness of Coaching on Adherence towards Guidelines for Prevention of Ventilator-Associated Pneumonia and Clinical Outcomes
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Abstract
This quasi-experimental research aimed to compare the adherence towards guidelines for the prevention of ventilator-associated pneumonia (VAP) and clinical outcomes, including the incidence rate of VAP, the length of intubation, the hazard ratio of successful extubation, tracheostomy incidents, length of hospital stay, and costs of treatment between a reference group (usual care) and the intervention group (coaching following Hass’ conceptual framework). The study was conducted in four medical wards in Mae Sot Hospital, Tak Province. Purposive sampling was performed to recruit 64 nurses and 150 ventilated patients aged 15 years or older during the study period. Data collection tools consisted of 1) the Nosocomial Surveillance Form, and 2) an observation checklist. The proportion of accurate nursing practices adhering to guidelines for the prevention of VAP, the duration of mechanical ventilation, tracheostomy incidents, length of hospital stays, and cost of treatment between groups were analyzed using descriptive statistics, Wilcoxon's rank-sum and chi-square test. The VAP incidence rate was estimated using Poisson regression. The hazard ratio of successful extubation along the cohorts was analyzed in a Cox proportional hazards regression model. The results revealed that staff nurses in the intervention group significantly more increased accurate practices
adhering towards guidelines for the prevention of VAP than those in the reference group. The VAP incidence rate significantly more decreased three times in the experimental group than the reference group. The mean intubation period significantly decreased among the experimental group. The hazard ratio of successful extubation significantly more increased in the experimental group 2.05 times than in the control group. Tracheostomy, length of hospital stays, and total cost were significantly lower among patients in the experimental group than those in the reference group. In conclusion, coaching staff nurses to adhere to guidelines for the prevention of VAP in this study improved nursing care practice and clinical outcomes.
Article Details
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
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