Relative factors on implementation defect of bundle care program in ventilator-associated pneumonia

Abstract

Objective To explore the relative factors on implementation defect of bundle care program in prevention of ventilator-associated pneumonia (VAP) in patients with endotracheal intubation. Methods The clinical data of 72 patients with endotracheal intubation in medical intensive care unit (MICU) of a classⅢ grade A hospital in Beijing from January 2015 to June 2015 were collected. They were divided into the group of defect (n=30) and the group of non-defect (n=42) according to the existence of implementation defect of bundle care program. The relative factors of implementation defect were analyzed. Results The score of Glasgow was (10.70±3.91) in the group of defect, which was higher than that in the group of non-defect (t=2.434, P=0.017) . The proportion of application of CRRT was 50% in the group of defect higher than that in the group of non-defect (χ2=2.434, P=0.011) . The nurse-patient ratio was (0.46±0.03) in the group of defect lower than that in the group of non-defect (t=2.060, P=0.043) . The multi-factor analysis showed the high score of Glasgow, application of CRRT and low nurse-patient ratio was the risk factors of the occurrence of implementation defect of bundle care program in prevention of VAP (P<0.05) . Conclusions The implementation defect of bundle care program in precaution of VAP is affected not only by the knowledge-attitude-practice of staff, but also by many objective factors from patients and environment. The managers should reply with a positive attitude so as to improve nursing outcomes. Key words: Ventilator-associated pneumonia; Bundle care; Implementation defect; Relative factors