Assessment of a training programme for the prevention of ventilator-associated pneumonia.
BACKGROUND
Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention.


OBJECTIVE
To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance.


METHODS
A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase.


RESULTS
Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37).


CONCLUSIONS
The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance.
Critical Care Centre, Hospital de Sabadell, Sabadell, Spain. rjam@tauli.cat
M Rosa
MR
Jam Gatell
Montserrat
M
Santé Roig
Óscar
Ó
Hernández Vian
Esther
E
Carrillo Santín
Concepción
C
Turégano Duaso
Inmaculada
I
Fernández Moreno
Jordi
J
Vallés Daunis
D002983:Clinical Competence; D003422:Critical Care / Q000379:methods*; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control*; D004509:Education, Nursing, Continuing / Q000379:methods*; D019983:Guideline Adherence; D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000150:complications* / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires