Reducing paediatric ventilator-associated pneumonia – a South African challenge!

Kunzmann, Heide; Dimitriades, Konstantinos; Morrow, Brenda; Argent, Andrew C.

doi:10.7196/sajcc.2016.v32i1.243

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…FEASIBILITY: Clinic costs and transportation times were also listed as issues that might inhibit this strategy’s successful implementation; Some TB patients stated they liked the home-based method better, as it allowed patients to feel more comfortable, less costs, but it did have the potential to create stigma; In terms of the material-based method, many participants stated food and money were good incentives, yet they questioned if the government would be able to implement this form of incentive system. Additional concerns related to this method were around if this method was sustainable.21Kunzmann et al [67]“Best Care Always:” an evidence- based HCAI prevention bundle1. PLAN: (consensus from local stakeholders agreed that a VAP bundle needed to be implemented on PICUs)2.…”

Section: Resultsmentioning

confidence: 99%

Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review

et al. 2019

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BackgroundDespite impressive reductions in infectious disease burden within Sub-Saharan Africa (SSA), half of the top ten causes of poor health or death in SSA are communicable illnesses. With emerging and re-emerging infections affecting the region, the possibility of healthcare-acquired infections (HAIs) being transmitted to patients and healthcare workers, especially nurses, is a critical concern. Despite infection prevention and control (IPC) evidence-based practices (EBP) to minimize the transmission of HAIs, many healthcare systems in SSA are challenged to implement them. The purpose of this review is to synthesize and critique what is known about implementation strategies to promote IPC for nurses in SSA.MethodsThe databases, PubMed, Ovid/Medline, Embase, Cochrane, and CINHAL, were searched for articles with the following criteria: English language, peer-reviewed, published between 1998 and 2018, implemented in SSA, targeted nurses, and promoted IPC EBPs. Further, 6241 search results were produced and screened for eligibility to identify implementation strategies used to promote IPC for nurses in SSA. A total of 61 articles met the inclusion criteria for the final review. The articles were evaluated using the Joanna Briggs Institute’s (JBI) quality appraisal tools. Results were reported using PRISMA guidelines.ResultsMost studies were conducted in South Africa (n = 18, 30%), within the last 18 years (n = 41, 67%), and utilized a quasi-experimental design (n = 22, 36%). Few studies (n = 14, 23%) had sample populations comprising nurses only. The majority of studies focused on administrative precautions (n = 36, 59%). The most frequent implementation strategies reported were education (n = 59, 97%), quality management (n = 39, 64%), planning (n = 33, 54%), and restructure (n = 32, 53%). Penetration and feasibility were the most common outcomes measured for both EBPs and implementation strategies used to implement the EBPs. The most common MAStARI and MMAT scores were 5 (n = 19, 31%) and 50% (n = 3, 4.9%) respectively.ConclusionsAs infectious diseases, especially emerging and re-emerging infectious diseases, continue to challenge healthcare systems in SSA, nurses, the keystones to IPC practice, need to have a better understanding of which, in what combination, and in what context implementation strategies should be best utilized to ensure their safety and that of their patients. Based on the results of this review, it is clear that implementation of IPC EBPs in SSA requires additional research from an implementation science-specific perspective to promote IPC protocols for nurses in SSA.

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Section: Resultsmentioning

confidence: 99%

Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review

et al. 2019

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“…Similarly, El‐Saed et al (2016) reported significant compliance among health‐care providers and a notable reduction in the rate of VAP in three Middle Eastern countries following implementation of the VAP prevention bundle. Investment in education for undergraduates and postregistration education, training of nurses and instituting VAP prevention policies and protocols are vital for a significant reduction in the incidence of VAP and the cost of care (Kunzmann, Dimitriades, Morrow, & Argent, 2016). Improvement of the organizational structure and modification of policies might overcome the lack of resources such as equipment including kinetic beds and closed system suction.…”

Section: Discussionmentioning

confidence: 99%

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

Aloush

Al-Rawajfa

2020

Int J of Nursing Practice

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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 ventilatorassociated 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.

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“…A local study done in the PICU at Red Cross War Memorial Children’s Hospital in 2011 reported a very high VAP rate of 55/1 000 ventilator days. [8] The VAP rate decreased to 19/1 000 ventilator days in the first 5 months after the implementation of a care bundle which consisted of the following five elements:…”

Section: Introductionmentioning

confidence: 99%

“… Positioning of ventilator tubing in such a manner that condensed water runs away from the patient into the water trap. [8] …”

Section: Introductionmentioning

confidence: 99%

Ventilator-associated pneumonia in PICU – how are we doing?

Wyk

Applegate

Salie

2022

South Afr J Crit Care

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Introduction. Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in children, leading to an increase in morbidity and mortality. A previous study in 2013 showed that VAP rates decreased dramatically after implementation of a VAP bundle and appointing a VAP coordinator. As part of a ‘Plan, Do, Study, Act’ cycle, it was necessary to evaluate the efficacy of these interventions.Objective. To evaluate the VAP rate in the paediatric intensive care unit (PICU) over 2 years (2017 - 2018), and to describe the causative organisms and antibiotic sensitivity/resistance patterns during this period. Methods. This was a retrospective, descriptive study using the existing PICU VAP database as well as clinical folders.Results. Over the 2 years, 31 VAP cases were identified. The VAP rate for 2017 was 4.0/1 000 ventilator days and 5.4/1 000 ventilator days for 2018. Compliance with the VAP bundle was 68% in 2017 and 70% in 2018. The median (interquartile range (IQR)) duration of ventilation in 2017 was 9 (6 -12) days and 15 (11 - 28) days in 2018. The median (IQR) length of PICU stay in 2017 was 11 (8 - 22) days and 25 (17 - 37) days in 2018. The most common cultured organism was an extended-spectrum beta-lactamase (ESBL) Klebsiella pneumoniae sensitive to amikacin and carbapenems. Conclusion. Our VAP rate has not decreased since 2013. It is imperative that we improve compliance with the VAP bundle, in order to reduce VAP rates. K. pneumoniae and Pseudomonas aeruginosa were the most common organisms causing VAPs and empiric use of piptazobactam and amikacin is still appropriate.

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Reducing paediatric ventilator-associated pneumonia – a South African challenge!

Cited by 5 publications

References 13 publications

Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review

Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review

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

Ventilator-associated pneumonia in PICU – how are we doing?

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