Program evaluation of ventilator-associated pneumonia bundle and development of a modified program

Purpose: Identify barriers and facilitators of adherence with the implemented VAP bundle through program evaluation using the Systems Engineering Initiatives for Patient Safety (SEIPS) model by exploring the work system, work process, and outcomes as a basis for developing recommendations for quality improvement. Methodology: Survey questionnaires on critical care nurses' demographics, VAP knowledge, and adherence to evidence-based guidelines on VAP prevention and the VAP bundle audit data were used to evaluate the work system, work process, and outcomes using descriptive analysis. Results: A total of 97 nurses from designated critical care areas were recruited to participate in a survey with a 33% response rate (n=32). A frequency analysis of the respondents’ demographics indicated that 74% of the respondents have critical care experience of more than 10 years (n=24), and the majority have acquired a bachelor’s degree and higher (65.6%). VAP knowledge survey shows a total mean score of 62.81%. The task adherence rate of the critical care nurses was 94.2%, and the work process adherence rate was 91.8%. Inadequate resources was identified as the most common barrier towards the evidence-based guideline for VAP prevention. Implications for Practice: Results indicated that lack of knowledge, length of nursing experience, and inadequate resources affect VAP prevention compliance. Identifying barriers and facilitators can be the pathway to redesigning practice change through education and training.D.N.P.Includes bibliographical reference