The barriers to the prevention of ventilator-associated pneumonia from the perspective of critical care nurses: A qualitative descriptive study
The barriers to the prevention of ventilator-associated pneumonia from the perspective of critical care nurses: A qualitative descriptive study
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DOI：
10.1111/jocn.14216
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发表时间：
2018-03-01
影响因子：
4.2
通讯作者：
Yazdannik, Ahmadreza
中科院分区：
文献类型：
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作者：
Atashi, Vajihe;Yousefi, Hojatollah;Yazdannik, Ahmadreza
目的和目的本研究的目的是探讨伊朗重症监护护士对重症监护室呼吸机相关性肺炎预防障碍的看法。背景大多数重症监护室住院患者需要机械通气。机械通气最常见和最严重的并发症之一是呼吸机相关性肺炎。预防此类肺炎存在不同的障碍。设计采用定性描述性设计。方法在本次定性研究中，通过立意抽样的方式招募了23名重症监护护士。为了收集数据，进行了半结构化访谈。访谈采用数字化记录、逐字转录，并采用归纳内容分析法进行分析。结果预防呼吸机相关肺炎的障碍主要分为三大类，即护士专业能力有限、环境条件不利和人力资源管理被动。这些大类中的10个小类分别是专业态度不佳、专业知识有限、工作积极性低、专业责任感有限、物质结构不标准、设备不足或不合适、工作量大、人员短缺、人员培训不足和监管不力。结论重症监护病房预防呼吸机相关肺炎的障碍非常多样和复杂，包括各种相互关联的个人、环境和组织障碍。呼吸机相关性肺炎的预防。此外，强调了充足的资源、充足的人员配备和适合具体情况的循证指南对于有效预防呼吸机相关肺炎的重要性。
Aims and objectivesThe aim of this study was to explore the perspectives of Iranian critical care nurses on the barriers to ventilator-associated pneumonia prevention in intensive care units.BackgroundMost patients hospitalized in intensive care units need mechanical ventilation. One of the most prevalent and serious complications of mechanical ventilation is ventilator-associated pneumonia. There are different barriers to the prevention of this kind of pneumonia.DesignQualitative descriptive design was used.MethodsIn this qualitative study, 23 critical care nurses were recruited via purposive sampling. Semi-structured interviews were done for data collection. The interviews were recorded digitally, transcribed word by word, and analyzed using the inductive content analysis approach.ResultsThe barriers to the prevention of ventilator-associated pneumonia fell into three main categories, namely nurses' limited professional competence, unfavorable environmental conditions, and passive human resource management. The 10 subcategories of these main categories were unfavorable professional attitude, limited professional knowledge, low job motivation, limited professional accountability, non-standard physical structure, inadequate or inappropriate equipment, heavy workload, staff shortage, inadequate staff training, and ineffective supervision.ConclusionThe barriers to the prevention of ventilator-associated pneumonia in intensive care units are very diverse and complex and include a wide range of interrelated personal, environmental, and organizational barriers.Relevance to clinical practiceThis study created a better understanding of the barriers to ventilator-associated pneumonia prevention. Moreover, highlighted the importance of sufficient resources, adequate staffing level, and contextually-appropriate evidence-based guidelines for effective ventilator-associated pneumonia prevention.