Strategi Intervensi Edukasi untuk Mendukung Penerapan VAP Bundle oleh Perawat ICU: A Scoping Review

Septa Permana, Cecep Eli Kosasih, Ristina Mirwanti

Abstract


Latar Belakang: Ventilator Associated Pneumonia (VAP) merupakan salah satu komplikasi serius pada pasien di ruang Intensive Care Unit (ICU) yang berkontribusi terhadap tingginya angka morbiditas dan mortalitas. Perawat berperan penting dalam mencegah VAP melalui implementasi VAP bundle. Meskipun pedoman pelaksanaan telah tersedia, praktik di lapangan masih kurang optimal. Oleh karena itu, peningkatan pengetahuan perawat menjadi hal krusial dalam menurunkan kejadian VAP. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi berbagai intervensi yang dapat meningkatkan pengetahuan perawat dalam pelaksanaan VAP bundle di ICU melalui pendekatan scoping review. Metode: Penelitian ini menggunakan desain scoping review dengan pendekatan PCC framework (Population: perawat; Concept: intervensi peningkatan pengetahuan; Context: ICU). Artikel yang dikaji merupakan publikasi tahun 2016–2021, berbahasa Inggris, dan tersedia dalam full-text. Pencarian dilakukan pada beberapa basis data elektronik, yaitu Cochrane Library, ProQuest, PubMed, EBSCOhost, Science Direct, Clinical Key, SAGE Journals, dan Google Scholar. Proses seleksi mengikuti alur PRISMA flow chart, dilanjutkan dengan ekstraksi dan sintesis data. Hasil: Dari 945 artikel yang ditemukan, dilakukan penyaringan hingga diperoleh 10 artikel yang sesuai dengan kriteria inklusi. Hasil analisis menunjukkan bahwa intervensi yang dapat meningkatkan pengetahuan perawat mencakup: program edukasi dan pelatihan, modul e-learning, program pengajaran terstruktur, serta penerapan panduan praktik keperawatan. Kesimpulan: Berbagai intervensi edukatif terbukti efektif dalam meningkatkan pengetahuan perawat terkait pelaksanaan VAP bundle di ICU. Diperlukan pelatihan berkelanjutan yang disertai supervisi, pengawasan, dan monitoring untuk mendukung implementasi VAP bundle secara optimal dalam praktik klinis


References


Abou Zed, S. A. F., & Mohammed, A. A. (2019). Impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Journal of Nursing Education and Practice, 9(10), 15. https://doi.org/10.5430/jnep.v9n10p15

Adiyeke, E., Koc, B. I., Coskun, N., Bakan, N., Sen, E., Turan, A., & Ozturk, H. (2021). The Impact of a Multidisciplinary Education Program for Intensive Care Unit Staff Regarding Ventilator Care Bundle on the Frequency of Ventilator-Associated Events. Dimensions of Critical Care Nursing, 40(4), 210–216. https://doi.org/10.1097/DCC.0000000000000484

Agarwal, S., Kakati, B., & Rana, P. (2019). Effectiveness of Staff Education on Prevention of Ventilator-Associated Pneumonia and Recent Trends of Antimicrobial Susceptibility of Organism Causing VAP in ICU. 66–72.

Al-Sayaghi, K. (2014). Prevention of ventilator associated pneumonia: a knowledge survey among intensive care nurse in Yemen. Saudi Med J., 35(3), 269–275.

Aloush, S. M. (2017). Does educating nurses with ventilator-associated pneumonia prevention guidelines improve their compliance? Am J Infect Control, 45(9), 969–673. https://doi.org/10.1016/j.ajic.2017.04.009

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. Int J Soc Res Methodol, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616

Azab, S. F. A., Sherbiny, H. S., Saleh, S. H., Elsaeed, W. F., Elshafiey, M. M., Siam, A. G., Arafa, M. A., Alghobashy, A. A., Bendary, E. A., Basset, M. A. A., Ismail, S. M., Akeel, N. E., Elsamad, N. A., mokhtar, W. A., & Gheith, T. (2015). Reducing ventilator-associated pneumonia in neonatal intensive care unit using “VAP prevention Bundle”: A cohort study. BMC Infectious Diseases, 15(1), 4–10. https://doi.org/10.1186/s12879-015-1062-1

Aziz, Z., Kausar, S., Zahid, S., Farooqi, S., Aziz, Z., & Ahmad, R. A. (2020). Knowledge and practice of ventilator care bundle for preventing ventilator associated pneumonia by ICU nurses of tertiary care hospitals of Lahore. Anaesthesia, Pain and Intensive Care, 24(4), 426–434. https://doi.org/10.35975/apic.v24i4.1315

Branco, A., Lourençone, E. M. S., Monteiro, A. B., Fonseca, J. P., Blatt, C. R., & Caregnato, R. C. A. (2020). Education to prevent ventilator-associated pneumonia in intensive care unit. Revista Brasileira de Enfermagem, 73(6), e20190477. https://doi.org/10.1590/0034-7167-2019-0477

Budiono, P. (2013). Hubungan Antara Lama Penggunaan Ventilator Mekanik Dengan Kejadian Ventilator Associated Pneumonia (VAP) Pada Pasien Nonsepsis di ICU RSUP Dr. Kariadi Semarang. Jurnal UNDIP.

Cal, P. (2015). Ventilator-Associated Pneumonia Prevention Bundle.

Center for Dissease Control and Prevention (CDC). (2021). Pneumonia (Ventilator-associated [VAP] and nonventilator-associated Pneumonia [PNEU]) Event.

Chithra, R. A., & Raju, J. (2017). Effect of Structured Teaching Programme on Knowledge Regarding Prevention of Ventilator Associated Pneumonia among Critical Care Nurses. International Journal of Health Sciences & Research, 7(7), 156–163. www.ijhsr.org

Cooper, V. B., & Haut, C. (2013). Preventing Ventilator-Associated Pneumonia in Children: An Evidence-Based Protocol. Critical Care Nurse, 33(3), 21–29. https://doi.org/https://doi.org/10.4037/ccn2013204

Damayanti, M., & Handiyani, H. (2021). Low compliance, limited facilities, and insufficient budget funds become obstacles in the implementation of infection and prevention control programs: A phenomenology study. Enfermería Clínica, 31(2), S45–S49. https://doi.org/https://doi.org/10.1016/j.enfcli.2020.10.016

Dipanjali, R., Shivananda, P. M., & Yashoda, S. (2021). Effectiveness of an Educational Intervention on Knowledge and Practice of Staff Nurses on Prevention of Ventilator Associated Pneumonia (VAP) Among Neonates in NICU. International Journal of Caring Sciences, 14(1), 8–17. http://internationaljournalofcaringsciences.org/docs/2_ mamantha_origina_14_1.pdf

Ferreira, C. R., de Souza, D. F., Cunha, T. M., Tavares, M., Reis, S. S. A., Pedroso, R. S., & Röder, D. V. D. de B. (2016). The effectiveness of a bundle in the prevention of ventilator-associated pneumonia. Brazilian Journal of Infectious Diseases, 20(3), 267–271. https://doi.org/10.1016/j.bjid.2016.03.004

Fitriani, D. (2018). Hubungan Pengetahuan Perawat Tentang Pencegahan Ventilator Associated Pneumonia (Vap) Dengan Peningkatan Angka Vap Di Ruang Icu Rumah Sakit Sari Asih Karawaci Tangerang. Edu Dharma Journal: Jurnal Penelitian Dan Pengabdian Masyarakat, 2(1), 46. https://doi.org/10.52031/edj.v2i1.30

Hawsawi, T. H., Al-Naghshabandi, E., & Sofar, S. M. (2017). Effectiveness of Electronic Learning Module in Implementing VentilatorAssociated Pneumonia Prevention Measures of Intensive Care Unit Nurses. Journal of Advance in Health and Medical Sciences, 3(3), 126–149. https://doi.org/10.33425/2639-9474.1062

Hussein, A. A. (2020). Knowledge of Nurses Concerning Ventilator-Associated Pneumonia ( VAP ) Prevention in Mosul Teaching Hospitals. 20(4), 14–20.

Ismail, R., & Zahran, E. (2015). The effect of nurses training on ventilator-associated pneumonia ( VAP ) prevention bundle on VAP incidence rate at a critical care unit. Journal OfNursing Education and Practice, 5(12), 42–48. https://doi.org/10.5430/jnep.v5n12p42

Joint Commission on the Accreditation of Healthcare Organizations. (2005). Candidate Core Measure Set

Khalifa, E. M., & Eldin, A. S. S. (2020). The impact of an Educational Training Program on Nurses in Reduction of Ventilator Associated Pneumonia. Egyptian Journal of Occupational Medicine, 44(3), 709–726. https://doi.org/10.21608/ejom.2020.118350

Lawn, S., Zhi, X., & Morello, A. (2017). An integrative review of e-learning in the delivery of self-management support training for health professionals. BMC Medical Education, 17(1). https://doi.org/10.1186/s12909-017-1022-0

Madhuvu, A., Endacott, R., Plummer, V., & Morphet, J. (2020). Nurses’ knowledge, experience and self-reported adherence to evidence-based guidelines for prevention of ventilator-associated events: A national online survey. Intensive and Critical Care Nursing, 59. https://doi.org/https://doi.org/10.1016/j.iccn.2020.102827

Ministry of Health of the Republic of Indonesia. (2017). Regulation of the Minister of Health of the Republic of Indonesia Number 27 of 2017 concerning Guidelines for Prevention and Control of Infections in Health Care Facilities.

Morris, A. C., Hay, A. W., Swann, D. G., Everingham, K., McCulloch, C., McNulty, J., Brooks, O., Laurenson, I. F., Cook, B., & Walsh, T. S. (2011). Reducing ventilator-associated pneumonia in intensive care: Impact of implementing a care bundle. Critical Care Medicine, 39(10), 2218–2224.

Noorifard, M., Farahani, R. H., & Hazrati, E. (2020). The incidence and risk factors of ventilator-associated pneumonia in ICU. Acta Medica Iranica, 58(9), 439–444. https://doi.org/10.18502/acta.v58i9.4765

Notoatmodjo, S. (2014). Ilmu Perilaku Kesehatan. Rineka Cipta

Oner Cengiz, H., & Kanan, N. (2019). The effectiveness of training given to nurses for reducing ventilator-associated pneumonia in intensive care patients. Developments in Health Sciences, 2(2), 36–45. https://doi.org/10.1556/2066.2.2019.006

Osti, C., Wosti, D., Pandey, B., & Zhao, Q. (2017). Ventilator-associated pneumonia and role of nurses in its prevention. Journal of the Nepal Medical Association, 56(208), 461–468. https://doi.org/10.31729/jnma.3270

Parisi, M., Gerovasili, V., Dimopoulos, S., Kampisiouli, E., Goga, C., Perivolioti, E., Argyropoulou, A., Routsi, C., Tsiodras, S., & Nanas, S. (2016). Use of ventilator bundle and staff education to decrease ventilator- associated pneumonia in intensive care patients. Critical Care Nurse, 36(5), e1–e7. https://doi.org/10.4037/ccn2016520

Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Scoping Reviews. In E. Aromataris & Z. Munn (Eds.), JBI Manual for Evidence Synthesis, JBI, 2020.

Rahmawati. (2014). Angka Kejadian Pneumonia Pada Pasien Sepsis di ICU RSUP Dr. Kariadi Semarang. Jurnal Medika Muda UNDIP Semarang, 3(1).

Rakhi, M., & Navita, R. (2020). Effectiveness of Structured Teaching Program on Knowledge and Practice Regarding Care Bundle on Prevention of Ventilator-Associated Pneumonia among Nurses. International Archives of Nursing and Health Care, 6(4), 3–7. https://doi.org/10.23937/2469-5823/1510149

Sadli, M. F., Tavianto, D., & Redjeki, I. S. (2017). Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif, 5(2), 85–93. https://doi.org/http://10.15851/jap.v5n2.1108

Safdar, N., Musuuza, J. S., Xie, A., Hundt, A. S., Hall, M., Wood, K., & Carayon, P. (2016). Management of ventilator-associated pneumonia in intensive care units: A mixed methods study assessing barriers and facilitators to guideline adherence. BMC Infectious Diseases, 16(1), 1–10. https://doi.org/10.1186/s12879-016-1665-1

Samra, S. R., Sherif, D. M., & Elokda, S. A. (2017). Impact of VAP bundle adherence among ventilated critically ill patients and its effectiveness in adult ICU. Egyptian Journal of Chest Diseases and Tuberculosis, 66(1), 81–86. https://doi.org/10.1016/j.ejcdt.2016.08.010

Silva, C. Da, & Junior, M. (2015). trategies for appropriate antibiotic use in intensive care unit. Einstein, 13(3).

Speck, K., Rawat, N., Weiner, N. C., Tujuba, H. G., Farley, D., & Berenholtz, S. (2016). A Systematic Approach for Developing a Ventilator-Associated Pneumonia Prevention Bundle. Am J Infect Control., 44(6), 652–656. https://doi.org/10.1016/j.ajic.2015.12.020.A

Tricco, A. C., Lillie, E., & Zarin, W. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med, 169(7), 467–473. https://doi.org/10.7326/M18-0850

Yuvaraj, Manivannan, D., Balasubramanian, K., Muthusamy, K. R., & Sivakumar, M. N. (2017). The Impact of Teaching on Nurses Knowledge to VAP Prevention Bundle. International Journal of Nursing Care, 5(1), 66. https://doi.org/10.5958/2320-8651.2017.00014.x

Zaiton, H. I., & Elhanafy, E. Y. (2015). Impact of Implementation Nursing Guidelines on Minimizing Ventilator Associated Pneumonia among Intensive Care PatientsNo Title. Advances in Life Science and Technology, 29(ISSN 2224-7181), 40–51.

Zaragoza, R., Vidal-cortés, P., Aguilar, G., Borges, M., Diaz, E., Ferrer, R., Maseda, E., Nieto, M., Nuvials, F. X., Ramirez, P., & Rodriguez, A. (2020). Update of the treatment of nosocomial pneumonia in the ICU. 1–13




DOI: https://doi.org/10.47007/ijnhs.v10i1.9170

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