رسائل ماجيستير
English
2023
Ventilator-associated pneumonia and the relationship between nurses’ compliance with ventilator-associated pneumonia bundles and patient-related outcomes in intensive care units in Oman
Gerald Matua Amandu, Fatma Ahmed Hamood Al-Harthiyah , Huda Al-Noumani
كلية التمريض-جامعة السلطان قابوس · عمان
Ventilator-associated pneumonia (VAP) is a significant healthcare-associated infection that can increase mortality rates, length of hospital stay, duration of mechanical ventilation, and overall healthcare costs. Compliance with evidence-based VAP prevention guidelines has been shown to reduce the incidence of VAP and improve patient outcomes. However, limited research has been conducted on adherence to VAP guidelines and their impact on patient outcomes in Oman.
Aim:
This study aimed to examine the incidence rate of VAP, assess nurses’ compliance with the VAP prevention bundle, and explore the relationship between this compliance and patient-related outcomes, including VAP incidence, length of hospital stay, number of ventilation days, and hospital costs.
Research Method:
A prospective quantitative epidemiological study with a descriptive correlational design was conducted at Sultan Qaboos University Hospital (SQUH) and the Royal Hospital. The study covered a six-month follow-up period from August 2022 to February 2023. All patients who were mechanically ventilated for 48 hours or more in the intensive care units (ICUs) were included. Data were analyzed using descriptive statistics, Chi-square tests, independent t-tests, and Spearman’s rank correlation.
Results:
A total of 103 patients were included in the study. Among them, 22.3% developed VAP during the six-month follow-up period, corresponding to a VAP rate of 5.6 per 1,000 ventilator days. Nurses' overall compliance with the VAP bundle in both hospitals was 69%, though compliance decreased over the duration of patient hospitalization. Higher compliance with the VAP bundle was significantly associated with shorter hospital stays, fewer mechanical ventilation days, and lower hospital costs. Furthermore, VAP occurrence was lower among patients for whom the VAP bundle was properly implemented.
Conclusion:
This study underscores the critical role of adherence to VAP prevention guidelines in improving patient outcomes in ICUs. The findings highlight the need for healthcare institutions to prioritize strategies that enhance compliance with VAP bundles. Future research should investigate the factors influencing nurses' adherence to these guidelines to inform the development of effective interventions. Continuous quality improvement initiatives and regular audits of VAP bundle implementation are essential to minimize infections, prevent complications, and promote patient safety and positive health outcomes.