Clinical Assessment of Nursing Care Regarding Prevention of Ventilator-associated Pneumonia in Neonates

Document Type : Original Article

Authors

1 School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

4 Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Ventilator-associated pneumonia (VAP) is the second common nosocomial infection in NICUs leading to some complications. Nurses are one of the main resources in health care that directly influence neonatal health care. Responsibility of most of preventive strategies related to VAP complications lies with nurses; therefore, nursing care should be assessed until the nurses show standard level of performance in hospitals. The aim of this cross-sectional study, conducted within 2015-2016, was to assess nursing care regarding VAP prevention in neonatal intensive care units (NICUs) in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences.
Methods: In this descriptive cross-sectional study, 100 observations of nursing care regarding VAP were selected by convenience method in NICUs of Mahdiyeh, Mofid, and Imam Hossein hospitals affiliated to Shahid Beheshti University of Medical Sciences within 2015-2016. The data collection tools included demographic information questionnaire and a developed checklist related to VAP prevention. The observations were assessed and documented with two sampling methods, including time and event sampling. The data were analyzed in SPSS software (version 16).
Results: According to the results of the current study, the rate of compliance of nursing care with the standards for prevention of VAP in neonates under mechanical ventilation in NICU with developed standards was estimated at 62.81 percent.
Conclusion: Authorities should pay more attention to nursing cares especially incompetent cares explained in this study to increase the health of hospitalized neonates, decrease complications, length of stay, and costs. Moreover, future research is needed to investigate the reasons of this incompetency.

Keywords

References

1. Wijesooriya LI, Jayaratna HS, Wanasinghe DS. Exploring the cause of an outbreak of neonatal sepsis following ventilator-associated pneumonia in a base hospital, Sri Lanka 2018. 19th Conference on Postgraduate Research, International Postgraduate. University of Kelaniya, Sri Lanka; 2018.
2. Malhotra P, Kumar N, Thapar K, Bagga AK. Comparative study of incidence, risk factors, etiological agents and outcome of early and late ventilator associated pneumonia in paediatric intensive care unit at a tertiary care centre. Int J Contemp Pediatr. 2018; 5(3):708-13.
3. Gupta S, Sinha S. Care of the ventilated infant. Pediatr Child Health. 2009; 19(12):544-9.
4. Said A. Knowledge and practice of intensive care nurses on prevention of ventilator associated pneumonia at muhimbili national Hospital. Dar es Salaam, Tanzania. [Doctoral Dissertation]. Tanzania: Muhimbili University of Health and Allied Science; 2012.
5. Yazdani M, Sabetian G, Ra'ofi SH, Roudgari A, Feizi M. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit. J Adv Med Educ Professionalism. 2015; 3(2):68.
6. Cernada M, Brugada M, Golombek S, Vento M. Ventilator-associated pneumonia in neonatal patients: an update. Neonatology. 2014; 105(2): 98-107.
7. Fallahi M, Dasht AS, Naeempour N, Bassir M, Ghadamli P. Ventilator-associated pneumonia in hospitalized newborns in a neonatal intensive care unit. Arch Pediatr Infect Dis. 2014; 2(3):e16514.
8. Garland JS. Strategies to prevent ventilator-associated pneumonia in neonates. Clin Perinatol. 2010; 37(3):629-43.
9. Zhou Q, Lee SK, Jiang SY, Chen C, Kamaluddeen M,
Hu XJ, et al. Efficacy of an infection control program in reducing ventilator-associated pneumonia in a Chinese neonatal intensive care unit. Am J Infect Control. 2013; 41(11):1059-64.
10. Goerens A, Lehnick D, Büttcher M, Daetwyler K, Fontana M, Genet P, et al. Neonatal ventilator associated pneumonia: a quality improvement initiative focusing on antimicrobial stewardship. Front Pediatr. 2018; 6:262.
11. Sodhi MK, Kumar GA, Singh K, Kumar A, Malhotra S, Neki N. Incidence, clinical and microbiological pattern of ventilator associated pneumonia (VAP) in neonatal intensive care unit in Amritsar, India. Int J Curr Res Med Sci. 2018; 4(2):21-30.
12. Afjeh SA, Sabzehei MK, Karimi A, Shiva F, Shamshiri AR. Surveillance of ventilator-associated pneumonia in a neonatal intensive care unit: characteristics, risk factors, and outcome. Arch Iran Med. 2012; 15(9):567-71.
13. Moradi M, Nili F, Nayeri F, Amini E, Esmaeilnia T. Study of characteristics, risk factors and outcome for Ventilator Associated Pneumonia in Neonatal Intensive Care Unit patient. Tehran Univ Med J. 2013; 71(6):373-81.
14. Ceballos K, Waterman K, Hulett T, Makic MB. Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU. Adv Neonatal Care. 2013; 13(3):154-63.
15. Iosifidis E, Pitsava G, Roilides E. Ventilator-associated pneumonia in neonates and children: a systematic analysis of diagnostic methods and prevention. Future Microbiol. 2018; 13(12):1431-46.
16. Foglia E, Meier MD, Elward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clin Microbiol Rev. 2007; 20(3):409-25.
17. Brito DV, Brito CS, Resende DS, Moreira do Ó J, Abdallah VO, Gontijo Filho PP. Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study. Rev Soc Bras Med Trop. 2010; 43(6):633-7.
18. Chawla R. Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia in Asian countries. Am J Infect Control. 2008; 36(4 Suppl):S93-100.
19. Goldsmith JP, Karotkin E, Suresh G, Keszler M. Assisted ventilation of the neonate e-book: evidence-based approach to newborn respiratory care. New York: Elsevier Health Sciences; 2016.
20. Aelami MH, Lotfi M, Zingg W. Ventilator-associated pneumonia in neonates, infants and children.
Antimicrob Resist Infect Control. 2014; 3(1):30.
21. Lucas A. The effect of a nurse-respiratory therapist weaning protocol on the duration of mechanical ventilation and the incidence of ventilator-associated pneumonia. Huntington, United States: The Graduate School of Marshall University; 2008.
22. McBeth CL, Montes RS, Powne A, North SE, Natale JE. Interprofessional approach to the sustained reduction in ventilator-associated pneumonia in a pediatric intensive care unit. Crit Care Nurse. 2018; 38(6):36-45.
23. Zolfaghari M, Aeen FB, Noghabi AA, Mehran A. Effects of active and passive implementation of ventilator associated pneumonia guideline on nurses’ performance in critical care units: a controlled clinical trial. Nurs Pract Today. 2015; 1(3):126-34.
24. Thelan LA. Critical care nursing: diagnosis and management. Missouri: Mosby Inc: CV Mosby; 1994.
25. Aeen FB, Zolfaghari M, Asadi Noghabi AA, Mehran A. Nurses' performance in prevention of ventilator associated pneumonia. Hayat. 2013; 19(3):17-27.
26. Gonçalves FA, Brasil VV, Ribeiro LC, Tipple AF. Nursing actions for the prevention of ventilator-associated pneumonia. Acta Paulista Enfermagem. 2012; 25:101-7.
27. Ali NS. Critical Care Nurses' knowledge and compliance with ventilator associated pneumonia bundle at Cairo university hospitals. Crit Care. 2013; 4(15):66-78.
28. Tajalli S, Nourian M, Rassouli M, Baghestani AR. Clinical assessment of nursing care regarding hemovigilance in neonatal wards and neonatal intensive care units in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences (2013-2014). Iran Red Crescent Med J. 2015; 17(7):e19987.
29. Jiang K, Wang C, Sun C, Zhong H, Yan S, Zhou S. Ventilator-associated pneumonia in premature newborns admitted to the intensive care unit. Int J Clin Exp Med. 2018; 11(5):4695-701.
30. Geslain G, Guellec I, Guedj R, Guilbert J, Jean S, Valentin C, et al. Incidence and risk factors of ventilator-associated pneumonia in neonatal intensive care unit: a first French study. Minerva Anestesiol. 2018; 84(7):829-35.
31. Tolentino-DelosReyes AF, Ruppert SD, Shiao SY. Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia. Am J Crit Care. 2007; 16(1):20-7.
Iranian Journal of Neonatology
Volume 10, Issue 4
November 2019
Pages 19-24

Files

Share

How to cite

Statistics