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Renáta Zoubková
University of Ostrava, Czech RepublicTitle: Preventive measures to reduce the incidence of VAP in ICU nursing care
Abstract
Introduction: Pneumonia in patients on mechanical ventilation is the most frequently observed infectious complication in intensive care patients. The aim of this thesis was to evaluate the effect of measures in the prevention of ventilator-associated pneumonia. The partial goals were to evaluate the influence of the semirecumbent position, pressure in the obturation cuff of cannula, oral hygiene with antiseptics, subglottic aspiration, of the prescribed physiotherapy and of the timeliness of prescribed physiotherapy on the origination of ventilator-associated pneumonia.Further objectives included the evaluation of influence of selected risk factors that may affect the origination of ventilator-associated pneumonia (age, sex, type of admission, duration of ventilation and reintubation).
Methods: The research group consisted of 778 patients hospitalized at the Department of Anaesthesiology, Resuscitation and Intensive Care, University Hospital Ostrava in the period from January 2016 to December 2018. Data were obtained by retrospective analysis of the protocol of preventive measures of ventilator -associated pneumonia and subsequently were statistically processed. For testing the difference in the occurrence of preventive / risk factors were used the non-parametric tests: chi-square test, Wilcoxon (Man-Whitney) test for two selections and Kruskal-Wallis test. Statistical tests were evaluated at a significance level of 5%.
Results: The results of the survey showed that there are statistically significant differences in the observance of the semirecumbent position, in adherence of the pressure in the obturation cuff of the cannula and in the timeliness of the prescribed physiotherapy. A statistically significant difference was also confirmed for most risk factors (age, type of admission, duration of ventilation, reintubation).
Conclusion: Based on these findings, it can be stated that the preventive measures setup at the monitored workplace are adequate. It seems appropriate to use a package of preventive measures focused on a specific workplace, together with staff training and regular audits.
Biography
Renáta Zoubková is working as a teaching faculty of intensive medicine, algotherapy, and nursing at the Department (Faculty), Department of Anaesthesiology, Resuscitation and Intensive Care Medicine (Faculty of Medicine), University of Ostrava, Czech Republic. She is also working as a nurse in University Hospital Ostrava.
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