Practices and Obstacles in Prevention of Ventilator-Associated Pneumonia Among Registered Nurses in Intensive Care Units
Keywords:
Ventilator-associated pneumonia, Practices, Obstacles, Prevention, Intensive Care UnitsAbstract
Correct practices in the prevention of ventilator-associated pneumonia (VAP) can prevent mechanically ventilated patients from getting hospital-acquired pneumonia. This descriptive study aimed to determine practices among registered nurses and their obstacles in the prevention of VAP. The sample included 262 registered nurses working in the Intensive Care Units (ICUs) of three tertiary care hospitals under the Ministry of Public Health. Data were collected from March to May 2018 using a self-administered questionnaire consisting of three parts: general information, practice, and obstacles in prevention of VAP. The content validity of the questionnaire was examined by six experts with a content validity index of 0.95 for practice and 0.94 for obstacles. The reliability of the practice and obstacle sections were 0.94 and 0.74, respectively. Data were analyzed using descriptive statistics.
The study results revealed that the participant practice of the following nine main prevention activities were at a good level: hand hygiene, patient positioning, caring of tracheostomy, practicing oral hygiene, suctioning, nasogastric tube feeding, weaning of ventilator, caring of the endotracheal tube and the ventilator circuit, and managing environment. However, the regular practice of the following activities were low: scrubbing hands completely for at least 30 seconds with water and antiseptic (44.7%) and measuring the endotracheal tube cuff pressure before suctioning (32.8%). Obstacles in the prevention of VAP included personnel, support and management. Significant obstacles identified were insufficient manpower (26.2%) and urgency in patient lifesaving (20.2%).
This study indicated the necessity of promoting correct hand hygiene practices and providing sufficient manpower so that registered nurses in the ICUs can effectively prevent VAP.
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