title: Nurse-led implementation of a ventilator-associated pneumonia care bundle in a children's critical care unit.
abstract: Ventilator-associated pneumonia (VAP) is the leading cause of death with hospital-acquired infections, and preventing it is one of the Saving Lives initiatives ( Department of Health 2007 ). This article discusses the implementation of a purpose-designed VAP care bundle in a children's intensive care unit and examines the unique role of nurses in the management of the change process. A nurse-led VAP education, implementation and surveillance programme was set up. Nurse education was paramount, as nursing staff acceptance and involvement was a key feature. A multi-method training strategy was implemented, providing staff with multiple training opportunities and introducing VAP project education as a routine part of staff induction. Bundle compliance was monitored regularly and graphs of the results produced quarterly; feedback proved to be useful in keeping staff informed and engaged in VAP reduction. Comparison of VAP incidence before and after introduction of the care bundle showed a reduction after its implementation. With a co-ordinated, multidisciplinary approach, VAP care bundles can result in significant and sustained reductions in VAP rates in the paediatric intensive care unit. Effective co-ordination and leadership is crucial to successful implementation of the VAP bundle, and nurses are well placed to undertake this role.
authors.affiliation: John Radcliffe Hospital, Oxford.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hill
mesh_terms: D002648:Child; D002675:Child, Preschool; D004509:Education, Nursing, Continuing / Q000379:methods; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration*; D064872:Patient Care Bundles / Q000379:methods*; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000451:nursing
keywords: care bundles; child health; children’s critical care; nurse-led implementation; paediatric intensive care; ventilator-associated pneumonia