Monika Kumari and Rajpati Amrawat
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Background: Healthcare professionals and patients encounter numerous challenges in dealing with emerging treatment methods and their effects. Intensive care units experience a significantly higher rate of hospital-acquired infections than regular hospital wards. These include infections related to catheters, pneumonia associated with ventilators, and infections at surgical sites. Such nosocomial infections lead to increased death rates, illness, and medical expenses. Prolonged hospital stays, extended intensive care unit stays, and increased mechanical ventilation duration are evident in affected patients. The use of invasive devices stands out as a major risk factor for nosocomial infections in intensive care units, emphasizing the importance of adhering to preventive measures. The commitment of intensive care unit staff to evidence-based infection control measures plays a critical role in mitigating nosocomial infections. It is imperative to implement preventive strategies founded on sound evidence to curb the incidence of hospital-acquired infections. Many cases of ventilator-associated pneumonia originate from inhaling oropharyngeal secretions laden with potentially harmful microorganisms. To a lesser extent, the inhalation of gastric secretions might also play a role in ventilator-associated pneumonia development. The natural protective mechanisms against aspiration are compromised by tracheal intubation, making mechanical ventilation a significant risk factor for ventilator-associated pneumonia. Consequently, patients with pulmonary infections face financial strain beyond the treatment of their initial condition. Ventilator-associated pneumonia, a secondary issue that can arise from intubation and mechanical ventilation, is largely preventable. A set of interventions, known as the ventilator-associated pneumonia prevention bundle has been effective in reducing its occurrence. Objectives: (1) To assess the influence of nursing-led interventions on preventing ventilator-associated pneumonia among critically ill patients within both experimental and control groups. (2) To find out the association of nurse-led intervention with selected demographic variables and clinical profiles of critically ill patients at the selected intensive care unit of Pt. B.D. Sharma PGIMS, Rohtak. Materials and Methods: The researcher conducted the study using a quasi-experimental research approach and pre-experimental research design on 40 patients admitted to the cardiothoracic and vascular surgery intensive care unit of Pt. B.D. Sharma PGIMS, Rohtak, by using a nonprobability consecutive sampling technique. The same patients were assigned equally to experimental groups 1(20) and control 2 (20). VAP prevention was determined with the help of the clinical pulmonary infection score tool on day 5. The data was evaluated with an unpaired t-test and Chi-squared test. Result: The study shows that in the experimental group, 25% (five patients) using mechanical ventilators were free from infection. Within the same group, 55% (11 patients) experienced mild infections, while 20% (four patients) faced severe infections. Conversely, in the control group, 35% (seven patients) had mild infections, and a significantly higher percentage, 65% (13 patients), suffered from severe infections. This indicates that patients in the experimental group predominantly had milder infections compared to those in the control group, where severe infections were more common. Conclusion: The study’s goal was to evaluate how effective the ventilator bundle was at preventing ventilator-associated pneumonia in patients using mechanical ventilation in the specified cardiothoracic and vascular surgery intensive care unit at Pt. B.D. Sharma PGIMS, Rohtak. Results showed that the ventilator bundle successfully reduced the incidence of ventilator-associated pneumonia in the experimental group of patients. Furthermore, no notable link was found between the effectiveness of ventilator-associated pneumonia prevention and various demographic factors in either the experimental or control groups. As a result, research hypothesis H2 was rejected at a significance level of p ≥ 0.05.
Keywords: Knowledge, compliance, ventilator-associated pneumonia bundle, patient outcomes, nurses working in intensive care units
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