ABSTRACT
Pneumonia has accounted for approximately 15 percent of all hospital-associated infections and 27 percent and 24 percent of all infections acquired in the medical intensive-care unit (ICU) and coronary care unit, respectively. It has been the second most common hospital-associated infection after that of the urinary tract. Because of this tremendous risk, in the last two decades, most of the research on hospital-associated pneumonia has focused on ventilator-associated pneumonia. This study was aimed to assess effi ciency of nursing care package on expected outcome regarding prevention of ventilator associated pneumonia among ventilated clients. A quantitative research approach with quasi experimental research design with pre-and post-test with equivalent control group design was used to carry out the study. Ventilated clients from selected hospitals who were fulfi lling the inclusion criteria were selected by using non-probability convenient sampling technique. Total 40 (20 experimental and 20 control group) size sample was included in the study. In experimental group, majority (50%) had mild infection and only 15 percent had no infection in pre-test; in post-test majority (75%) had no infection and only 25 percent had mild infection and no patient had severe infection. It showed that delivery of nursing care package is effective in decreasing ventilator associated pneumonia. In control group, majority (50%) had mild infection and only 10 percent had no infection in pre-test and in post-test majority (40%) had mild infection and 60 percent had severe infection and no patient had severe infection. As nursing care package was not delivered, the infected cases increased. The effi ciency of nursing care package on expected outcome regarding prevention of ventilator-associated pneumonia between experimental groups was statistically signifi cant and in control group it was not signifi cant. The delivered nursing care package on ventilator-associated pneumonia among ventilated clients proved its benefi cial effects in controlling infection level and preventing ventilator-associated pneumonia at intensive care units. This study confi rmed that nursing care package for ventilated clients can prevent infection and cut short long stay in intensive care units.
ABSTRACT
Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.