Effect of Implementing The Protective Nursing Care Bundle of Ventilator Associated Pneumonia on Its Incidence among Critically Ill Children

Abstract

Ventilator-associated pneumonia is the most common hospital-acquired infection and associated with an increased mortality rate among critically ill children. So, the protection of mechanically ventilated critically ill children from ventilator-associated pneumonia is the primary responsibility of pediatric critical care nurses. Objective: To determine the effect of implementing the protective nursing care bundle of ventilator associated pneumonia on its incidence among critically ill children. Settings: This study was conducted at two pediatric intensive care units of Smouha Children’s University Hospital in Alexandria and Beheira Specialized Children's Hospital in Markaz Abu Humus, El Beheira Governorate. Subjects: Thirty critically ill children on invasive mechanical ventilation for more than 72 hours, ranged from one to 12 years old, recently admitted and free from any infection and immune-compromised diseases. Method: Two tools were used to collect the necessary data; “Characteristics and medical data of critically ill children record”, as well as “The Centers for Disease Control and “Prevention PNU-1 criteria for diagnosis of ventilator-associated pneumonia checklist”. Critically ill children received the protective nursing ventilator-associated pneumonia bundle care daily for seven consecutive days. Every critically ill child was assessed daily for seven consecutive days for incidence of ventilator-associated pneumonia. Results: The main study findings showed that early onset of ventilator-associated pneumonia was noticed among 33.3% of critically ill children, while none of them developed late onset of ventilator-associated pneumonia across the studied days. Conclusion: the implementation of protective nursing ventilator-associated pneumonia bundle care potentially had a positive impact on its incidence among mechanically ventilated critically ill children. Recommendations: pediatric critical care nurses should apply protective nursing care ventilator-associated pneumonia bundle based on recent evidence-based guidelines for all mechanically ventilated critically ill children.