Evidence-Based Nursing to Reduce Adverse Events Regarding Ventilator Associated Pneumonia, Pressure Injuries and Central Line Bloodstream Infection in Intensive Care Unit: A Quasi-experimental Study in Bangladesh
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 272
- 试验地点
- 3
- 主要终点
- The nurse's skill related to the PU, MDRPU and CLABSI total score measured by the researcher-developed checklist
研究概览
简要总结
Quality of care is crucial for preventing adverse events such as infection in the intensive care units (ICUs). The most common ICU-acquired infections include pneumonia such as Ventilator Associated Pneumonia (VAP), Pressure Ulcer (PU), Medical Device Related Pressure Ulcer (MDRPU), and Central Line-Associated Bloodstream Infection (CLABSI). VAP, PU, and MDRPU are significant indicators of the quality of care, while CLABSI is a critical marker of healthcare quality in ICUs, as it is largely preventable through strict adherence to infection control protocols.
VAP is a lung infection that occurs in patients receiving mechanical ventilation for more than 48 hours. A PU is defined as localized damage to the skin or underlying tissue caused solely by pressure, while MDRPUs may also result from friction or pressure from medical devices or other objects. CLABSI is a severe infection caused by improperly inserted or maintained central venous catheters, which underscores the need for stringent catheter management protocols.
详细描述
General Objective:
The objective of this study is to evaluate whether implementing EBP and changing nurses' competency (skill, knowledge, practice, and attitude) can reduce ICU adverse events such as VAP, PU, MDRPU, and CLABSI, and improve patient outcomes.
Specific Objectives:
- To identify insights on perceptions, barriers, and facilitators related to EBP implementation in the ICU setting.
- To evaluate the effect of EBP training on nurses' competency (skill, knowledge, practice, and attitude) regarding EBP for CLABSI, PU, and MDRPU in an ICU setting.
- To evaluate the effects of EBP on ICU patient incidence rates of VAP, CLABSI, PU, and MDRPU.
Hypothesis:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Trial 1 & 2-
- •Inclusion Criteria:
- •who is a registered nurse in Bangladesh.
- •who agrees to participate in this study and the EBP training.
- •who will stay at the ICU for 6 months. Patient
- •Irrespective of age and sex, participants must be at least 18 years old
- •Legal guardian of a patient consent to participation in the study
排除标准
- •Who will not directly involve patient care in ICU. Patient
- •No exclusion criteria
研究组 & 干预措施
Experimental: Trial 1: All Nurses in GICU; Trial 2: All patients admitted in the general GICU
Nurses: All nurses who work at GICU of DMCH Patients: all patients who will admit at the assigned GICU during the study period of DMCH
干预措施: Education with EBP (Behavioral)
Experimental: Trial 1: All Nurses in GICU; Trial 2: All patients admitted in the general GICU
Nurses: All nurses who work at GICU of DMCH Patients: all patients who will admit at the assigned GICU during the study period of DMCH
干预措施: This is a pre- and post- quasi-experimental study. (Behavioral)
结局指标
主要结局
The nurse's skill related to the PU, MDRPU and CLABSI total score measured by the researcher-developed checklist
时间窗: 6 month data collection and total time frame of this study 16 months
1\. The nurse's skill and knowledge related to the PU, MDRPU and CLABSI checklist. Researcher developed checklist, 50 items with 0: not correct/did not do, 1: partially correct, 2: correct. Score range 0-114.
Incidence rates of PU, MDRPU and CLABSI.
时间窗: 2 month for data collection and total time frame 16 months.
The incidence rate of PU was calculated as the number of newly developed pressure ulcers after hospitalization per 1000 person-days at risk. The incidence rate of MDRPU was calculated as the number of newly developed MDRPU cases per 1000 patients assessed. The incidence rate of CLABSI was calculated as the number of CLABSI cases per 1000 central line-days. Data will be collected: Patients' demographic data (age, sex, occupation etc.) Medical past and current history (diagnosis, treatment, medication, hospitalization). Reasons and date to be admitted to ICU. Treatment in ICU. Daily laboratory data taken in ICU. Daily biological data including vital signs. Results of patients' stay during ICU. Diagnosis of PU, MDRPU and CLABSI included of this list.
次要结局
- Nurses' knowledge, Attitude and Practice (KAP) related to the PU, MDRPU and CLABSI prevention measured by the researcher-developed scale based on Knowledge of EBP guidelines for the PU, MDRPU and CLABSI prevention scale(Total data collection time 6 months within 16 months)
- Rate (number of patients) of each stage of PU and MDRPU(Total 2 months)
- Micro-organism link to CLABSI(2 months)
- Incidence and rate of VAP(2 months)
- Mortality and morbidity rate of adverse events(2 months)
- Average length of stay ICU patients(2 months)
- Survival rate of ICU(2 months)
研究者
Nahida Akhter
Principal Investigator, Ph.D Fellow, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.
Hiroshima University