Marjon Borgert

140 Chapter 6 DuBose 45 2008, USA Ventilator bundle Pre/post design Baseline: 1 month. Inter- vention period 3 month Single center, trauma ICU Compliance ICU sta NS Item-by-item measurement/ Per month 1) Quality Round Checklist (QRC) developed by multidisciplinary team; 2) education; 3) multidis- ciplinary team to enhance implementation; 4) laminated yers, Pre-intervention: HOB: 35,2%, PUD prophylaxis 76,2%, DVT prophylaxis (91,2%), Sedation holiday: 78%. Implementa- tion month 3: HOB: 84,5%, PUD prophylaxis 92,3%, DVT prophylaxis 92,8, Sedation holiday: 86% Berenholtz 46 2011, USA, Ventilator bundle Pre/post design Baseline: 3 months. Post in- tervention: 0-30 months after implementation Multi center, 112 mixed, medi- cal, surgical/ trauma, cardi- ac ICUs Quarterly VAP rates Compliance ICU teams Model for organizatio- nal change (i.e. engage, educate, execute, evaluate) Theory of planned behavior Composite + Item-by-item/ Per quarter 1) local improvement team (ICU director and ICU nurse manager, ICU physician, nurse and senior hospital executive); 2) sta engagement by posting baseline compliance and VAP rates and discussing patients who developed VAP; 3) education (fact sheet, summary guidelines, a slide set en references); 4) daily goal checklist; 5) create protocols and order sets; 6) enlist support from clinicians and family members; 7) feedback: monthly number patients who developed VAP and bundle comp- liance and quarterly rates of VAP; 8) show reports of other ICUs to compare performance. Baseline: 1881/5789 (32%) Intervention period: 48% Post intervention quarterly: 0-3 months: 50,%, 28-30 month: 84% Lim 47 2013, Taiwan, Ventilator Bundle Pre/post design Jan’06-Mar’13 Tertiary referral med- ical center. Surgical ICU 63 beds ICU utilization, ventilator utilizati- on, VAP incidence, compliance Nurses, doctors, respi- ratory therapists NS AON/ Overall: 1 year 1) education; 2) posters; 3) checklists; 4) standar- dizing medical interventions and equipment. Post intervention (after re-education): doctors: 99%, nurses: 89.3%, respiratory therapists: 84%. Mukhtar 48 2014, Egypt, Ventilator bundle Pre/post design Mar’11-Jun’12 University hospital. Surgical ICU: 8 beds - VAP rates caused by MRSA - compliance Nurses NS AON/ Overall: 1 year 1) education; 2) rewards to motivate nurses for perfect ful lment of the VCB. Compliance ranged from 60%-70% Eom 49 2014, South Korea Ventilator bundle Quasi-exp: Pre/post design Pre-intervention: Jul’11-Feb’11, Post interven- tion: Mar ’11- Jun ‘11 Multicentre, 6 University hospitals. 196 ICU beds VAP rates 23 doc- tors, 318 nurses NS AON + Item- by-item/ Overall: 4 months 1) Education on VAP and VAP bundle; 2) checklists; 3) regular feedback on compliance; 4) nurses intervened at the time of monitoring if non-compliance with a bundle element was detected. Overall compliance (without CASS): Pre intervention: 41.1%, post intervention: 71.8%. Hamisheh- kar 50 2014, Iran, Ventilator bundle Obser- vational study Pre-post design Pre-education phase: 45 days, education phase, post edu- cation phase: 1 month after the education phase ended. Multicentre, 4 university a liated hospitals. 3 surgical, 2 general, 2 pulmonary, 1 neurosurgical, 1 neuro ICU Compliance 143 nurses: 127 (89%) females; age (me- an±sd): 33±5; workexp: (me- an±sd): 10±4yrs NS AON, Mean compliance/ Time period not clear 1) education, educational pamphlets containing results of VAP bundle compliance in each ICU and VAP bundle control guidelines and delivered them to every nurse whose practice was evaluated. Pre-education (N=294): 36.5%, post education (N=258) 41.2%.P > 0.05