Efektivitas VAP Bundle pada Pasien yang Terpasang Ventilasi Mekanik di Ruang Perawatan Intensif: Sebuah Systematic Review

Septa Permana, Cecep Eli Kosasih, Ristina Mirwanti

Abstract


Ventilator Associated Pneumonia (VAP) merupakan infeksi nosokomial yang paling sering terjadi pada pasien yang terpasang ventilator. Pencegahan VAP harus dilakukan sebagai salah satu isu yang paling penting di tatanan keperawatan kritis dan hal ini sudah menjadi salah satu core intensive care unit yang termasuk kedalam salah satu penilaian Joint Commission on Accreditation of Healthcare Organizations. Perawat memiliki peran sangat penting dalam upaya pencegahan terjadinya VAP ini. Tujuan dari systematic review ini adalah untuk mengidentifikasi efektivitas VAP bundle pada pasien yang terpasang ventilasi mekanik di ruang perawatan intensif. Penelitian dilakukan menggunakan pendekatan systematic review. Pencarian artikel melalui CINAHL dari EBSCOhost, Google Scholar, Medline, PubMed, Cochrane Library, dan Proquest dengan menggunakan kata kunci intensive care unit (ICU), mechanical ventilator (MV), nursing intervention, prevention, ventilator, ventilator associated pneumonia (VAP), ventilator associated pneumonia (VAP) bundles. Kriteria inklusi terdiri dari penelitian jenis randomized controlled trials (RCT), quasi-experimental, dan observational; tersedia dalam Bahasa Inggris; tersedia full-text; tahun publikasi 2009-2019; dan spesifik pada pertanyaan utama yang menjadi fokus review. Data dianalisis menggunakan Critical Appraisal Tools dari JBI (Joanna Briggs Institute). Peneliti menemukan 693 artikel dan hanya 10 artikel yang masuk kedalam kriteria review. Hasil dari tinjauan ini menunjukkan bahwa dengan mengimplementasikan VAP bundle terbukti dapat menurunkan angka kejadian VAP, menurunkan mortalitas pasien, meningkatkan patient outcomes, menurunkan lama rawat, dan menurunkan biaya perawatan. Pelaksanaan VAP bundle ini membutuhkan kerjasama tim yang baik dan dukungan institusi. Beberapa upaya pencegahan VAP tersebut sangat berkaitan erat dengan perawatan yang perawat lakukan setiap hari kepada pasien dan hal ini terbukti efektif dalam mengurangi angka kejadian VAP.

Kata Kunci: ruang perawatan intensif, ventilasi mekanik, Ventilator Associated Pneumonia (VAP) bundle. 


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DOI: https://doi.org/10.47007/ijnhs.v8i1.6479

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