title: Estimated nursing workload for the implementation of ventilator bundles.
abstract: BACKGROUND
  Ventilator-associated pneumonia is a common healthcare-associated infection with high attributable morbidity and mortality. Prevention strategies, including prevention bundles, have been widely adopted across the USA. However, the nursing resources required to implement these bundles, and their effect on other aspects of intensive care unit patient care, are unknown.
  
  
  METHODS
  We conducted a survey of all critical care nurses at our institution to determine the time required, and impact of, a prevention bundle at our hospital.
  
  
  RESULTS
  Nurses estimated that the standard ventilator bundle requires a median of 115 min (IQR: 74-182) per patient per day. Although the majority of nurses did not perceive that other patient care tasks were delayed by these prevention activities, this was not universal; 29% (95% CI 21% to 39%) of respondents reported that other patient care tasks were sometimes delayed because time was allocated to ventilator bundle activities.
  
  
  CONCLUSIONS
  Our estimates may serve as potentially important inputs for cost-effectiveness and decision analyses related to intensive care unit prevention activities. Further research should include direct observations about nursing time allocation related to prevention activities.
authors: Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. wbranche@bidmc.harvard.edu
authors: Westyn
authors: W
authors: Branch-Elliman
authors: Sharon B
authors: SB
authors: Wright
authors: Jean M
authors: JM
authors: Gillis
authors: Michael D
authors: MD
authors: Howell
mesh_terms: D002983:Clinical Competence; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000592:standards*; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000451:nursing*; D013997:Time Factors; D000078329:Workforce; D016526:Workload