Evaluation of staff education on ventilator bundle compliance in university Kebangsaan Malaysia medical centre [UKMMC] intensive care unit [ICU]

ABSTRACT

Ventilator associated pneumonia [VAP] has been associated with high morbidity and mortality rates especially in critically ill patients. Implementing the "ventilator bundle" series of interventions serves a pivotal role in reducing the incidence of VAP. This study was carried out to review compliance of the staff in UKMMC ICU towards ventilator bundle from August 2010 to March 2011. All medical and nursing staffs in ICU were given education by means of lectures, pamphlets, posters, and refresher sessions which were implemented in between two periods of assessment Compliance was assessed on daily basis at random throughout a 140-day course divided into 70 pre-educational days and 70 post-educational days. Pre-educational overall compliance achieved was 38.4%. Compliance of individual component was [1] head of bed [HOB] > 30 degrees 43.6%, [2] Peptic ulcer disease [PUD] prophylaxis 88.6% [3] Deep venous thrombosis [DVT] prophylaxis 86.7% [4] Sedation vacation 98.1% [5] Oral care 96.7%. Post-educational overall compliance achieved was 65.0% with each individual component achieving 67.6%, 97.7%, 89.6%, 97.4%, and 99.0% respectively. There were statistically significant increases [p<0.05] in overall compliance and 3 individual components i.e. HOB elevation, PUD prophylaxis and oral care. Implementation of education had resulted in improved compliance of some, but not all components of the ventilator bundle. Continuous staff education is recommended to ensure further improvement and maintenance in compliance amongst the multidisciplinary team who manage patients in ICU