Assessment of a training programme for the prevention of VAP
本帖最后由 拙凌 于 2013-2-1 13:49 编辑Assessment of a training programme for the prevention of ventilator-associated pneumonia
（在线阅读原文链接：http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506739/）
Abstract
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.
Aim
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.
Method
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.
Findings
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).
Conclusion
The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance.
Keywords: Education, Evidence-based nursing, Intensive care, Observation, Prevention, Ventilator-associated pneumonia
这是一篇VAP预防措施培训效果评估的文章，让我想起一碗水版主曾经提供的一篇关于手卫生的评估文章。
我们常常为了培训没有明显效果而感到懊恼，但是不是真的没有我们眼里看上去的很差呢？
这篇文章将VAP预防措施的培训分为三个阶段来研究：培训前、干预阶段、培训后。然后从各个角度来评估。
评估的重点在于如何评估？不是我们日常随机盲目地观察，而是应该有计划有针对性地设计好评估方案。
个人以为这是本文值得学习借鉴的地方。{:1_737:} 谢谢老师们的无私分享，下载学习了 英文看起来吃力来，请老师翻译好嘿嘿！{:1_1:}
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