NURSES’ KNOWLEDGE OF EVIDENCE-BASED GUIDELINES FOR PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA IN CRITICAL CARE AREAS: A PRE AND POST TEST DESIGN

Authors

  • Salima Moez Meherali
  • Yasmin Parpio
  • Tazeen S. Ali
  • Fawad Javed

Abstract

Background: Ventilator associated pneumonia (VAP) is a common hospital acquired pneumonia inventilated patients. VAP is associated with increased morbidity, mortality duration of hospitalizationand cost of treatment. Critical care nurses are usually unaware of evidence based preventiveguidelines for VAP, resulting in negative impact on all aspects of patient care. This studyinvestigated the impact of a 5-hour teaching module on nurses’ knowledge to practice evidencebased guidelines for the prevention of VAP. Methods: This study was conducted at a private tertiarycare teaching hospital in Karachi, Pakistan. Single group pre-test post-test design was used. Fortynurses were included in the study. The knowledge of nurses was assessed before, immediately afterand 4 weeks after the intervention. The final sample (n=40) was selected on the basis of the setinclusion criteria. The demographic data sheet was used to collect relevant information about theparticipants. Knowledge was assessed through a self-developed validated tool, consisting of multiplechoice questions. The difference in knowledge was analysed through repeated measures of analysisof variance. The mean scores at 3 time points were compared using the Tukey’s multiple comparisonprocedure. Results: Knowledge scores of participants increased significantly after the educationalintervention in the first post-test; however, there was a decline in the score in post-test 2.Conclusion: The 5-hour teaching module significantly enhanced nurses’ knowledge towardsevidence based guidelines for the prevention of VAP. Further research is needed to assess the impactof training on nursing practice and to explore factors affecting attitudinal change.Keywords: Critical care, Pneumonia, Ventilator associated pneumonia, evidence based practice, nurses’knowledge

References

Ruffell A, Adamcova L. Ventilator-associated pneumonia:

prevention is better than cure. Nurs Crit Care 2008;13(1):44–53.

Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, NicolasChanoin MH, et al. The prevalence of nosocomial infection in

intensive care units in Europe. Results of the European Prevalence

of Infection in Intensive Care (EPIC) Study. EPIC International

Advisory Committee. JAMA 1995;274:639–44.

Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. CDC;

Healthcare Infection Control Practices Advisory Committee.

Guidelines for preventing health-care--associated pneumonia, 2003:

recommendations of CDC and the Healthcare Infection Control

Practices Advisory Committee. MMWR Recomm Rep

;53(RR-3):1–36.

Augustyn B. Ventilator-Associated Pneumonia: Risk Factor and

Prevention. Crit Care Nurs 2007;27(4):32–9.

Salahuddin N, Zafar A, Sukhyani L, Rahim S, Noor MF, Hussain

K, et al. Reducing ventilator-associated pneumonia rates through a

staff education programme. J Hosp Infect 2004;57:223–7.

Rello J, Lorente C, Bodí M, Diaz E, Ricart M, Kollef MH. Why do

physicians not follow evidence-based guidelines for preventing

ventilator-associated pneumonia? a survey based on the opinions of

an international panel of intensivists. Chest 2002;122(2):656–61.

Babcock HM, Zack JE, Garrison T, Trovillion E, Jones M, Fraser

VJ, et al. An educational intervention to reduce ventilatorassociated pneumonia in an integrated health system: a comparison

of effects. Chest 2004;125:2224–31.

Creedon S. Health Care Workers’ hand decontamination practices:

an Irish Study. Clin Nurs Res 2006;15:6–26.

Joiner GA, Salisbury D, Bollin GE. Utilizing quality assurance as a

tool for reducing the risk of nosocomial ventilator associated

pneumonia. Am J Med Qual 1996;11:100–3.

Zack JE, Garrison T, Trovillion E, Clinkscale D, Coopersmith CM,

Fraser VJ, et al. Effect of an education program aimed at reducing

the occurrence of ventilator-associated pneumonia. Critical Care

Medicine 2002;30:2407–12.

van Nieuwenhoven CA, Buskens E, Bergmans DC, van Tiel FH,

Ramsay G, Bonten MJ. Oral decontamination is cost-saving in the

prevention of ventilator-associated pneumonia in intensive care

units. Critical Care Medicine 2004;32(1):126–30.

Cocanour CS, Ostrosky-Zeichner L, Peninger M, Garbade D,

Tidemann T, Domonoske BD, et al. Cost of a ventilator associated

pneumonia in a shock trauma intensive care unit. Surg Infect

;6:65–72.

Blot SI, Labeau S, Vandijck D, Van Aken P, Claes B. Evidencebased guidelines for the prevention of ventilator-associated

pneumonia: results of a knowledge test among intensive care

nurses. Intensive Care Med 2007;33:1463–7.

Soh KL, Koziol-Mclain J, Wilson J, Soh KG. Critical care nurses’

knowledge in preventing nosocomial pneumonia. Aust J Adv Nurs

;24:19–25.

American Thoracic Society, Infectious Diseases Society of

America. Guidelines for the management of adults with hospitalacquired, ventilator-associated, and healthcare-associated

pneumonia. Am J Respir Crit Care Med 2005;171:388–416.

Munro BH. Statistical Methods for Health care research. 4th ed.

Philadelphia: Lippincott; 2001.

PNC curriculum. Retrieved April 12, 2007 from www.pnc.org.pk

The theory- practice gap in nursing: The role of the nurse teacher.

Journal of Advanced Nursing 2000;32(6):1550–6.

Bruno P, Ongaro A, Fraser I. Long-term retention of material taught

and examined in chiropractic curricula: Its relevance to education

and clinical practice. J Can Chiropr Assoc 2007;51:14–8.

Sisson JC, Swartz RD, Wolf FM. Learning, retention and recall of

clinical information. Med Educ 1992;26:454–61.

Published

2011-03-01