SESSION TITLE: Outcomes/Quality Control Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Prevention methods play a key role in reducing VAP incidence, and these require significant educational commitments and high rates of compliance in order to achieve reduction in the incidence of VAP. The success of the bundle depends largely on the way it is implemented; therefore, performance of these must always be under constant review with surveillance of compliance. The main purpose of the study is to evaluate the compliance of the health care workers and to evaluate the actual practice of doctors and nurses including determination of barriers and obstacles.
METHODS: This is a cross sectional study involving adult intubated patients in the Central and the Medical ICU and the health care workers in the two month period. The following data were and analyzed: 1. direct observation of intubated patients - noting head of bed elevation, daily oral hygiene, DVT prophylaxis; 2. chart review of admitted patients - presence of VAP prevention bundle check list, VAP prevention bundle or components ordered by the physician; and 3. VAP bundles carried out by the nurses written on nurses notes and monitoring sheet. Survey questionnaires were also administered to health care workers to determine baseline knowledge of the VAP prevention bundles, including training received, perceived compliance and factors in its implementation. A second set of questionnaires were distributed to determine barriers and obstacles to the implementation of each of the components of the bundles of care.
RESULTS: Total of 62 admitted patients were included in the study; 26 from the medical ICU and 36 patients from the central ICU. Compliance to the bundles were computed as follows: number of vented patients receiving all components of bundle/total number of patients on ventilator for the day of the prevalence sample x100, result of which is 38.71%.
CONCLUSIONS: The general compliance to the VAP prevention bundle showed a rate of 38.71%. The two components with the lowest conformity were DVT prophylaxis and assessment for readiness to wean/sedation holidays.
CLINICAL IMPLICATIONS: In order to improve the compliance to the prevention bundle, it is important to include the provision of needs and funds for medications needed for stress ulcer and DVT prophylaxis. It is imperative to improve the facilities, especially repair of non working beds; periodic evaluation and assessment of the medical and nursing staff. Equally important is the stipulation of the VAP checklist and protocol as well as guidelines for weaning and sedation.
DISCLOSURE: The following authors have nothing to disclose: Gene Philip Louie Ambrocio, Abigail Uy, Albert Albay, Marissa Alejandria
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