Nursing students' knowledge about ventilator-associated pneumonia prevention guidelines: Effectiveness of a teaching program

How nursing students learn infection control education through undergraduate nursing programs: a phenomenographic research study

BACKGROUND

Competency in infection control is crucial for implementing nursing best practices to ensure patient safety. However, research is lacking on the infection control education received by nursing students prior to entering clinical settings as nurses. This study aimed to explore how nursing students conceptualize infection control care in undergraduate nursing programs.

METHODS

This study employed a qualitative research method using phenomenography. Universities providing undergraduate nursing programs in Korea. Thirty nursing students: 10 students each from the 2nd, 3rd, and 4th years of five undergraduate programs. Data were collected from May 2019 to February 2020 through semi-structured interviews and analyzed using a phenomenographic analysis procedure.

RESULTS

Six descriptive categories were derived inductively for nursing students' frames of reference regarding infection control care and six descriptive categories of how nursing students learned about infection control care. The structural framework of the identified categories, about how nursing students learn about infection control care, was presented as an outcome space.

CONCLUSIONS

Given that nursing students demonstrate diverse conceptualizations of infection control and are at varying levels of learning, professors and clinical mentors need to develop theoretical education and clinical practice opportunities that consider these differences.

Implementation of an educational module on nosocomial infection control measures: a randomised hospital-based trial

Background

Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses.

Methods

A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module “without training”. In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1^st May and 30^th October 2016.

Results

The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P < 0.001) and 3 months after the end of the intervention (MD = 4.48, P < 0.001) as compared to the waitlist group. Similarly, the results showed a statistically significant difference in the mean practice scores between the intervention groups immediately post-intervention (MD = 2.74, P < 0.001) and 3 months after the intervention (MD = 2.46, P < 0.001) as compared to the waitlist group. Intervention-1 (face-to-face training + module) was more effective than intervention-2 (module only) in improving Yemeni nurses’ knowledge and practices regarding NI control measures compared to the waitlist group.

Conclusion

The findings of this study found that intervention-1 could be offered to nurses in the form of an in-service training course every six months. The NI course should also be included in nursing curricula, particularly for the three-year-nursing diploma in Yemen.

Trial registration

Nosocomial infection educational module for nurses ISRCTN19992640, 20/6/2017. The study protocol was retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00551-0.

Prevention of ventilator-associated pneumonia in intensive care units: Barriers and compliance

AIM

The purpose of this study was to evaluate the compliance of Jordanian nurses with ventilator-associated pneumonia prevention guidelines and the barriers to compliance.

METHOD

A descriptive, cross-sectional design was used. A convenience sample of 294 nurses from nine hospitals in Jordan completed a self-reported questionnaire.

RESULTS

According to the study compliance categories, 45.6% of the participants reported 'insufficient compliance,' 24.8% 'weak compliance' and 29.6% 'sufficient compliance.' Nurses with more experience and previous education on ventilator-associated pneumonia reported higher compliance scores than their counterparts with less experience and no previous education. Nurses reported several barriers that limited their own compliance, such as lack of education, lack of policies and protocols, lack of resources and the shortage of staff.

CONCLUSION

The compliance of nursing staff with the prevention guidelines was poor. Applying tailored educational programs may help improve their level of compliance. These programs must target new graduate nurses and be conducted in those hospitals with limited resources.

Preventing ventilator-associated pneumonia-a mixed-method study to find behavioral leverage for better protocol adherence

OBJECTIVE

Preventing ventilator-associated pneumonia (VAP) is an important goal for intensive care units (ICUs). We aimed to identify the optimal behavior leverage to improve VAP prevention protocol adherence.

DESIGN

Mixed-method study using adherence measurements to assess 4 VAP prevention measures and qualitative analysis of semi-structured focus group interviews with frontline healthcare practitioners (HCPs).

SETTING

The 6 ICUs in the 900-bed University Hospital Zurich in Zurich, Switzerland.Patients and participantsAdherence to VAP prevention measures were assessed in patients with a device for invasive ventilation (ie, endotracheal tube, tracheostomy tube). Participants in focus group interviews included a convenience samples of ICU nurses and physicians.

RESULTS

Between February 2015 and July 2017, we measured adherence to 4 protocols: bed elevation showed adherence at 27% (95% confidence intervals [CI], 23%-31%); oral care at 41% (95% CI, 36%-45%); sedation interruption at 81% (95% CI, 74%-85%); and subglottic suctioning at 88% (95% CI, 83%-92%). Interviews were analyzed first inductively according a grounded theory approach then deductively against the behavior change wheel (BCW) framework. Main behavioral facilitators belonged to the BCW component 'reflective motivation' (ie, perceived seriousness of VAP and self-efficacy to prevent VAP). The main barriers belonged to 'physical capability' (ie, lack of equipment and staffing and side-effects of prevention measures). Furthermore, 2 primarily technical approaches (ie, 'restructuring environment' and 'enabling HCP') emerged as means to overcome these barriers.

CONCLUSIONS

Our findings suggest that technical, rather than education-based, solutions should be promoted to improve VAP prevention. This theory-informed mixed-method approach is an effective means of guiding infection prevention efforts.

Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines: A Middle Eastern Survey

This study was a self-reported cross-sectional survey that investigated nurses' and hospitals' compliance with ventilator-associated pneumonia prevention guidelines and the barriers and factors that affect their level of compliance. A questionnaire was completed by 471 intensive care unit nurses from 16 medical centers in 3 Middle Eastern countries: Jordan, Egypt, and Saudi Arabia. The results show that both nurses and hospitals have insufficient compliance. Previous education, experience, and academic degree were all found to affect nurses' compliance.

Nurses' implementation of ventilator-associated pneumonia prevention guidelines: an observational study in Jordan

BACKGROUND

Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable.

AIMS

The purpose of this study was to assess nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that influence their compliance.

DESIGN

A structured observational design with a non-participant approach.

METHOD

One hundred nurses were observed during their care for patients on mechanical ventilator. The observers documented nurses' implementation of ventilator-associated pneumonia prevention guidelines using a structured observational sheet.

RESULTS

Compliance of nurses was found to be unsatisfactory. Of the participants, 63% showed 'insufficient compliance'. Nurses working in units with a 1:1 nurse:patient ratio and lower beds' capacity demonstrated higher compliance and their intensive care units had a lower rate of ventilator-associated pneumonia and shorter intensive care unit stay in comparison with their counterparts working with a 1:2 nurse:patient ratio and higher beds' capacity.

CONCLUSION

Nurses' compliance with ventilator-associated pneumonia prevention guidelines was insufficient. Low nurse-patient ratio and large intensive care unit beds capacity were found to affect nurses' compliance and patients' outcomes. This study expanded knowledge about important aspects of nursing care; nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that affect their compliance. This knowledge can be used by health professional to guide the clinical practice and to improve the quality of care.