POSITIVE COMMENT –

Knowledge of nurses about the intervention for the prevention of pneumonia associated with mechanical ventilation:

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This article seeks to investigate the knowledge of pneumonia prevention interventions. There seems to be a disconnect between the evidence research has made available and clinical practice. One strength is that the method used allows for honest results. However, the weakness is that the study was conducted at one hospital, in one unit so the generalizability is unknown.

Wagner, B. V., Alves, E. F., Brey, C., Waldrigues, M. C., & Caveião, C. (2015). KNOWLEDGE OF NURSES ABOUT THE INTERVENTION FOR THE PREVENTION OF PNEUMONIA ASSOCIATED WITH MECHANICAL VENTILATION. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 9(5), 7902-7909. doi:10.5205/reuol.6121-57155-1-ED.0905201521

Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care: This article is aimed at evaluating compliance with a bundle to prevent ventilator-associated pneumonia in an Intensive Care Unit. Bundles are only effective if used appropriately and consistently. Nurses must understand and comply in order to reduce VAP in the ICU setting. One strength is that samples were taken from many settings and consisted of nearly 1,500 participants. One weakness is that VAP bundles are not universal and vary between facilities.

Guterres da S, Raquel Kuerten de S, Eliane Regina Pereira do N, Kátia Cilene Godinho B, Cibele D’Avila Kramer C. (2014). Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care. (3):744

Ventilator-associated pneumonia bundled strategies: an evidence-based practice: Ventilator-associated pneumonia (VAP) is an ongoing challenge for critical care nurses as they use current evidence-based strategies to decrease its incidence and prevalence. This article aims to provide a review of the literature on VAP bundle (VAPB) practices, describe the etiology and risk factors and define bundled practices, discuss an explanatory framework that promotes knowledge translation of VAPBs into clinical settings, and to identify areas for further research and implications for practice to decrease the incidence of VAP. One strength is multiple resources were used to provide reliable results. One weakness is that though bundles were proven effective overall, it does not specify or account for the different interventions that are in each bundle.

O’Keefe-McCarthy, S., Santiago, C., & Lau, G. (2014). Ventilator-associated pneumonia bundled strategies: an evidence-based practice. Worldviews On Evidence-Based Nursing, 5(4), 193-204

Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated pneumonia: There is an ongoing need for improvements in education and effective implementation strategies. Barriers in prevention of VAP include education or lack thereof and appropriate and consistent implementation. Strength is that it includes all barriers and provides a clear picture of the issues. A weakness is it relies on nurses to be honest about lack of compliance with existing bundles.

Jansson, M., Ala-Kokko, T., Ylipalosaari, P., Syrjälä, H., & Kyngäs, H. (2013). Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated pneumonia – A survey study. Intensive & Critical Care Nursing, 29216-227

Practical Nursing Assistants and Pneumonia Prevention Associated with Mechanical Ventilation in ICU: Assesses the knowledge of nurses in pneumonia prevention practices associated with mechanical ventilation in patients hospitalized in  intensive care unit. It identified the importance of the nurses´ role to care practices in the care of critically ill patients and the importance of recognizing the clinical findings to establish a diagnosis. The results provide subsidies for a reflection on the role of nurses in intensive care healthcare practices in the prevention of pneumonia in patients who are undergoing mechanical ventilation. One strength is that it includes the roles of support staff and their contributions to compliance. A weakness is that the roles of support staff are given through the opinions of ICU nurses.

Oliveira Gonçalves, É., Santos de Lima, M., de Lima Melo, J., Rodrigues Pontes, M. S., Barros Sousa, A. O., & Pinheiro Albernaz, M. (2015). Practical Nursing Assistants and Pneumonia Prevention Associated with Mechanical Ventilation in ICU. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 9(12), 1069-1077

Bundle to Prevent Ventilator-Associated Pneumonia: A Collective Constructive: This article reports on a qualitative convergent care research, which was aimed at the collective construction of a bundle to prevent ventilator-associated pneumonia by nursing and physiotherapy professionals at the intensive care unit. The construction of the VAP bundle was guided by the evidence-based practice criteria and consists of four preventive care acts: oral hygiene with 0.12% chlorhexidine; headboard elevated (30-45º); endotracheal cuff pressure between 20-30 cmH2O; and care with the aspiration of tracheal secretions. The implementation of these recommendations can support healthcare practice, contributing to reduce ventilator-associated pneumonia rates. A strength is it provides evidence of what an effective bundle is and how it can reduce incidence of VAP. A weakness is it does not provide evidence for each individual intervention or others that are included in bundles at other facilities.

Da Silva, S., do Nascimento, E., & de Salles, R. (2013). Bundle to Prevent Ventilator-Associated Pneumonia: A Collective Constructive. 21(4), 837-844

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