الفهرس 
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Abstract
Ventilator-Associated pneumonia is hospital acquired lung infections (HAI) and/ or complications that occur in patients receiving mechanical ventilation after 48hours when the patient is intubated and ventilated at the time or within 48 hours before the onset of the events. Best practice and preventive measures are important aspects of nursing care for patients’ who receive mechanical ventilation (MV). Nurses’ have taken an aggressive role in developing best practice standards (VAP bundle) in an attempt to prevent ventilator associated pneumonia (VAP). The ventilator associated pneumonia bundle recognized by institute of healthcare Improvement (IHI) and consist of a group of evidence-based practices that implemented together. In a recent observational study, the bundle includes, infection control measures (hand washing), positioning strategies, endotracheal suctioning care, ventilator circuit care, oral care, Peptic ulcer prophylaxis and DVT prophylaxis (Klompas, Kleinman, Murphy & Noomy 2012).
Aim of the study:
This study aims at assessing nurses’ performance regarding the prevention of ventilator associated pneumonia bundle in the intensive care units. This aim will be achieved through the following:
Assess the nurses’ Knowledge regarding the prevention of ventilator associated pneumonia bundle in the intensive care units.
Assess the nurses’ practices regarding the prevention of ventilator associated pneumonia in the intensive care units.
Research Questions:
The current study was answered the following questions:
What are the nurses’ knowledge regarding the prevention of ventilator associated pneumonia bundle in intensive care units?
What are the nurses’ practices regarding the prevention of ventilator associated pneumonia bundle in intensive care units?
Research design:
The study was descriptive exploratory study.
Setting:
The study was conducted at the Intensive Care Units in Helioplis Hospital.
Subject:
The present study included all the available nurses working at Intensive Care Units as a convenience sample, including (35) nurses after obtaining their consent to participate in the study. Their educational level was diploma, technical Institute or B.Sc. Nursing.
Tools of data collection:
Data were collected through using the following two different tools.
I- A self administered questionnaire (Appendix I): It was developed by the researcher in Arabic language based on review of relevant recent literature and consulting expertise in this area, it was used to assess nurses’ knowledge regarding the prevention of ventilator associated pneumonia bundle.
Demographic characteristics of the study nurses such as age, sex, qualifications and clinical experience.
Nurses’ knowledge related ventilator associated pneumonia will be included: definition, risk factors, sings & symptoms, complication and nursing management.
o In relation to nurses’ knowledge, each question was scored as ”0” for incorrect and ”1”for correct answer.
o The total score of the questionnaire was 149, the scores were distributed according to the importance of the items.
• Below 70% was graded as unsatisfactory.
• 70% and above was graded as satisfactory.
Based on reference (Ibrahim, 2014).
II- An observational checklist (Appendix II): It was developed by the researcher based on comprehensive reviewing and recent literature to assess the nurses’ performance for mechanically ventilated patients regarding ventilator associated pneumonia bundle in their work in intensive care units. It will be included: infection control measures (hand washing), positioning strategies, endotracheal suctioning care, ventilator circuit care, oral care, peptic ulcer prophylaxis and DVT prophylaxis.
o In relation to nurses’ practices, each point was scored as ”0” for not done,”1” for incorrectly done and ”2” for done correctly.
o The total score of the observation checklist were 552, the total items of checklist were 276 , the scores were distributed according to the importance of the items.
Below 70% was graded as unsatisfactory.
70% and above was graded as satisfactory.
Based on reference (Ibrahim, 2014).
Results:
The results of the study showed that:
The findings showed that two thirds of the study nurses had diploma holders who had less than one year of nursing experience, and their mean age was (29.22±9.18) years while all of the study nurses were males &females. Also it reveals that; the majority of them were females.
The findings revealed that none of the nurses’ had previous educational training courses about infection control practice.
The findings revealed that more than half of the studied nurses had satisfactory knowledge related to the prevention of ventilator associated pneumonia bundle.
Regarding total nurses’ practice, the results of the current study indicated that about more than half of the study nurses had a adequate practice regarding ventilator associated pneumonia bundle.
There was high statistically significant relation between nurses’ knowledge and their age.
There was highly statistically significant relation between the nurses’ knowledge and years of experience.
There is statistically significant relation between nurses’ practice and their age.
There was statistically significant difference between nurses’ practice and their gender.
There was statistically significant relation between the nurses’ practice and years of experience.
There was significant relationship between nurses’ knowledge and practice.
Conclusion
Based on findings of the current study, it can be concluded that the current study indicated that more than half of the study nurses had satisfactory knowledge and practice regarding ventilator associated pneumonia bundle. Moreover, there was statistical significant relation between total knowledge and practice as regards their demographic characteristics: age, gender, education and years of experience. The unsatisfactory nurses’ knowledge and inadequate practice related to ventilator associated pneumonia bundle may be a reason in the occurrence of ventilator associated pneumonia.
Recommendations:
Based on the findings of the present study, it recommended that:
An educational training program must be developed for nurses in intensive care units regarding ventilator associated pneumonia bundle.
Standard nursing procedures booklets should be available and developed in areas of Prevention of VAP.
Nurses should take initiative to improve their knowledge and practices by using online education, virtual learning, booklets, posters, brochures, charts etc.
Posters and simple illustrations about prevention of VAP should be available in every intensive care units.
The need for establishing a protocol to ensure that VAP prevention protocol will be implemented consistently in all ICUs.
There is a need implement all the individual elements of a bundle evidence-based practices when applied together they result in significantly better outcomes than when implemented individually.
Sufficient number of nurses with high qualification must be available.
The hospital should motivate more nurses to further their studies to degree level to enhance quality services in the specialized unit.
The unit’s administration should ensure the completeness of the care bundle checklists through supervision and compile monthly reports on VAP in the unit (internal audits) to aid evaluation.
A similar study should be done on a large sample and other place to generalize the findings.