Effect of Designed Bundle Protocol about Ventilator Associated Pneumonia on Nurses' Performance, Compliance, and Patient Outcomes

Abstract

Context: Ventilator-associated pneumonia (VAP) is considered one of the leading causes of morbidity and mortality due to nosocomial infections among ventilated patients.

Aim: To evaluate the effect of a designed bundle protocol about ventilator-associated pneumonia on nurses' performance, compliance, and patient outcomes.

Methods: The study employed the quasi-experimental research (pre/post-test) (study/control) design. This study was conducted at the intensive care unit of Benha University Hospital. A convenience sample of 50 critical care nurses and a purposive sample of 66 patients were enrolled in the current study. Three tools were used to collect data. Nurses' knowledge assessment questionnaire; nurses' practice assessment checklist; The VAP bundle compliance checklist; and patient outcomes assessment record.

Results: Statistically significant improvement in total knowledge and practice mean scores post implementing a designed bundle protocol compared to pre-implementing a designed bundle protocol at p <0.001. Also, there was a statistically significant improvement in nurses’ compliance with a highly statistically significant difference between nurses’ compliance with practices of VAP bundle pre-and post designed bundle protocol implementation. Immediately after a designed bundle protocol implementation, the study group patients exhibited a statistically significant difference between all clinical pulmonary infection scores items except for oxygenation status and radiographic findings.

Conclusion: The study group nurses who received designed bundle protocol training would get improved knowledge, practices, and compliance scores than pre-designed bundle protocol training. Also, the study group of patients who were cared for by trained nurses on the designed bundle protocol would get better outcomes such as a better score of CPIS, shorter length of stay in the intensive care unit, less duration on mechanical ventilation compared to the control group who received routine hospital nursing care. The study recommended replication of the study using a large probability sample from a different geographical area to allow for greater generalization of the results.