• The Journal of the Korea Contents Association
• /
• v.17 no.8
• /
• pp.241-249
• /
• 2017

This study was to determine the effectiveness of oral decontamination with chlorhexidine for prevention of ventilator associated pneumonia(VAP) using meta-analysis. MEDLINE, Pubmed, Cochrane library CINAHL and RISS, Koreamed, KISS databases were searched. key words used 'Ventilator-associated pneumonia', 'oral care', 'chlorhexidine' Ninety studies met the inclusion criteria for the meta-analysis. data were analyzed by the Revman 5.3 program of cochrane library and assessed for methodological quality using RoB (The Cochrane's Risk of Bias). The main findings of the current study suggest that chlorhexidine oral care have a positive impact on Ventilator associated pneumonia.

• The Journal of the Korea Contents Association
• /
• v.21 no.10
• /
• pp.630-644
• /
• 2021

This study was conducted to develop evidence-based nursing practice guideline for the prevention of VAP. This is a methodological study to develop guideline and verify the effectiveness according to the hybrid method of the NECA. Topics and key questions were derived through literature review and interviews, and recommendations were converged and developed through guidelines review and SR and meta-analysis. This was verified through the RAND and evaluated through AGREEII. The clinical feasibility of the nursing practice guideline, consisting of 44 recommendations in 9 categories, was evaluated by 122 ICU nurses. Conclusively this evidence-based nursing practice guideline for the prevention of VAP was confirmed methodological quality and content validity and was suitable for our nursing practice environment.

• Journal of Korean Clinical Nursing Research
• /
• v.16 no.3
• /
• pp.111-121
• /
• 2010

Purpose: This meta-analysis was aimed to investigate the evidence of proper period of the ventilator circuit change using existing research. Methods: For this study, 14 published studies between 1995 and 2010 were tested by Macaskill, Funnel Plot, the Odds Ratio of DerSimonian and Laird, Fisher and Liptak analysis. Results: There were no publication bias found in the subjects. The results of the meta-analysis demonstrated no statistically significant differences were observed in neither the Odds Ratio (OR=1.18, 95% CI=0.94-1.47) of the frequency of ventilator-associated pneumonia and the mortality based on the period of the ventilator circuit change (Fisher p=.332, Liptak p=.498), nor the ventilation duration of ventilator (Fisher p=.843, Liptak p=.506), and the hospital length of stay (Fisher p=.254, Liptak p=.480). Conclusion: In order to present more concrete guidelines on the period of the ventilator circuit change, further research is warranted to thoroughly control confounding variables which related to the periods of the ventilator circuit change.

• Journal of Home Health Care Nursing
• /
• v.25 no.3
• /
• pp.224-231
• /
• 2018

Purpose: This study was to analyze the factors affecting ventilator-associated pneumonia with severe trauma patients. Methods: This study conducted from May 1, 2018 to May 31, 2018 based on the medical records of the intensive care unit of a university hospital from May 1, 2017 to April 30, 2018 in Gangwon province. The inclusion criteria were 1) Trauma intensive care unit patient, 2) older than 19 years 3) without pneumonia at the time of admission. The collected data were analyzed using descriptive, correlation analysis, ANOVA, t-tests, $x^2$-tests and regression. Results: The severe trauma patients had a total of 2,877 days receiving ventilator, and nine VAP cases. The overall infection rate was 4.0%, and the VAP incidence rate was 3.13 per 1000 ventilator days. VAP in severe trauma patient affected ICU stay(OR=1.03), mechanical ventilator applied day(OR=1.04). Conclusion: Therefore, the development of an individualized VAP prevention bundle and nursing intervention for patients with trauma will be needed and further studies. In addition, there were no findings regarding the relationship between VAP occurrence and the severity of multiple traumatic injuries, so further studies of these factors should be performed.

• Journal of Korean Critical Care Nursing
• /
• v.4 no.2
• /
• pp.39-46
• /
• 2011

Purpose: The purpose of this study was to examine the effect of oral hygiene for ventilator-associated pneumonia (VAP) incidence. Methods: This study was used a nonequivalent control group posttest design. This study was performed in two groups, experimental group and control group. The experimental group (36 patients) had performed oral care for 6 times a day. The control group (39 patients) had followed and 3 times oral care a day. Participants were patients of 20 years of age or older on mechanical ventilation more than 48 hours from July 5 to October 31 in 2007 at the medical and surgical ICU of C university hospital. Results: VAP occurred in 5 cases in the control group, while only 1 case occurred in the experimental group. Incidence for 1000 ventilator day was 12.59 in the control group and 2.18 in the experimental group. Conclusion: Nursing intervention of 6 times oral care a day proved to decrease incidence of VAP. A guideline should be made using the above nursing intervention for the critical ill patients receiving mechanical ventilation.

• Journal of Korean Biological Nursing Science
• /
• v.20 no.4
• /
• pp.205-213
• /
• 2018

Purpose: The purpose of this study was to confirm the compliance of the application of a ventilator-associated pneumonia bundle and understand its effects on the decrease in the incidence of ventilator-associated pneumonia. Methods: This was a retrospective observational study with history control group design. Subjects were selected from January to June 2014, prior to the intervention using the ventilator-associated pneumonia bundle. Subjects were also selected from October 2014 to March 2015, 3 months after the intervention. The number of subjects was 112 before the intervention, and 107 after the intervention. Results: The number of nurses who followed the bundles increased from 8 out of 29 (27.6%) before the intervention to 19 out of 29 (65.5%) after the intervention (odd ratio= 4.99, confidence interval= 1.63-15.25, p= .004). There were 3 cases of ventilator-associated pneumonia before the intervention and 1 case after the intervention. The ventilator days were 2,143 days before the intervention and 2,232 days after the intervention. The ventilator-associated pneumonia rate of the 1,000 ventilator days was 1.40 before the intervention and decreased to 0.45 after the intervention. Conclusion: This study is meaningful, as there has been little research conducted regarding the application of the ventilator-associated pneumonia bundle in South Korea.

• Korean Journal of Adult Nursing
• /
• v.15 no.3
• /
• pp.463-471
• /
• 2003

Purpose: This study was aimed at providing scientific evidence for minimizing ventilator-associated pneumonia(VAP) by identifying appropriate timing of exchange of circuit for mechanical ventilator that is well suitable for the medical environment of intensive care units of hospitals in Korea. Method: This was a quasi-experimental study with a convenience sample of 19 adult subjects aged over 18 years who were admitted to the NS ICU of C university hospital, and placed on mechanical ventilator. The subjects were placed in two groups, compared on the incidence rate of VAP after they received exchange of circuit either at 1-week interval (N =10) or 2-week interval (N = 9). Result: 1) When considering 1000 days as the standard unit of analysis for incidence, the incidence rate of VAP was 7.19 cases at the 1-week cycle exchange group and 15.23 at the 2-week cycle exchange group, showing no statistically significant difference between the two groups. 2) There were a total of 3 types of bacteria isolated from the patients with VAP, including 2 cases with P. aeruginosa, 1 case with Streptococcus group F and A. baumannii. Conclusion: With thorough hand washing and strict management of tracheal tube of mechanical ventilator as well as use of tracheal intubation techniques, exchange cycle of circuit of mechanical ventilator by nurses may be changed from 1-week to 2-week interval.

• Journal of Korean Critical Care Nursing
• /
• v.3 no.2
• /
• pp.13-22
• /
• 2010

Purpose: This study was intended to examine the effects of educating the Ventilator-Associated Pneumonia (VAP) control for the nurses working in the intensive care unit (ICU). Methods: The study was conducted using one group pre-post test research design. The education on infection control was provided to 31 nurses working at the medical and surgical ICUs. A comparison was then made in terms of the degree of performing infection control a month before, two weeks after, and three months after the education respectively. The incidences of VAP at the medical and surgical ICUs were compared for 3 months before and after the education. Results: The average performance scores between before and after the education showed statistically significant differences. Compared to three months before, the incidence of VAP after the education was decreased slightly from 5.48 to 1.88 per 1,000 ventilator days. Conclusion: It is necessary to continue the VAP education, specifically on infection prevention and control methods and the consistent evaluation of its effects as well as the development of standardized educational program should be approached extensively in further studies.

• Korean Journal of Adult Nursing
• /
• v.21 no.2
• /
• pp.155-166
• /
• 2009

Purpose: This study developed and evaluated a systematic intervention among medical ICU nurses for preventing ventilator-associated pneumonia (hereafter VAP). Methods: A VAP prevention program was proposed based on a literature review, revised to fit the target situation, and validated. It was composed of one-time interventions including education, pamphlets, hand cultures, and a quiz event, as well as repeated interventions such as posters, reminders, posting hand culture results, and performance feedback. A simulated control group pretest-posttest design was used to verify the effectiveness of the VAP control program. The incidence of VAP among ICU patients was measured both during 3 months before (n=80) and during 3 months after (n=75) intervention. Results: The VAP prevention program's effectiveness, with a pre-intervention VAP rate of 17.38 and post-intervention rate of 11.04 per 1,000 ventilator days, showed a clinical tendency to decrease, but the difference was not statistically significant (p=.750). Conclusion: A VAP prevention program of multiple interventions can be useful in decreasing the VAP rate. Given that the monthly decrease in the VAP rate was not considered statistically significant, long-term research needs to be done. Additionally, since this study targeted only nurses, it is suggested that future research targets other health care workers who can influence VAP rates.

• Journal of Korean Critical Care Nursing
• /
• v.10 no.2
• /
• pp.14-23
• /
• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.