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  3. Investigating the level of awareness of special care nurses about the evidence-based guidelines for the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the health-treatment centers of the University of Medical Sciences and Health-Treatment Services, Gilan Province, 2013

Investigating the level of awareness of special care nurses about the evidence-based guidelines for the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the health-treatment centers of the University of Medical Sciences and Health-Treatment Services, Gilan Province, 2013

Number of pages: 74 File Format: word File Code: 32012
Year: 2013 University Degree: Master's degree Category: Paramedical
Tags/Keywords: Awareness of nurses - care - Consciousness - Evidence-based nursing - Hospital nursing staff - nursing - pneumonia - Prevention of pneumonia - Respiratory ventilator - Special care unit - Ventilator-dependent pneumonia
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  • Summary of Investigating the level of awareness of special care nurses about the evidence-based guidelines for the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the health-treatment centers of the University of Medical Sciences and Health-Treatment Services, Gilan Province, 2013

    Dissertation

    To obtain a master's degree in special care nursing

    Introduction: Evidence-based care is the application of the best research results, along with knowledge, expertise, clinical experiences and attention to patient values ??in the provision of care. For this purpose, the use of evidence-based guidelines and the quality review of evidence-based clinical care guidelines in care departments Especially, in the context of the most common complications in the department, it is necessary to improve care. In order to apply these principles, it is necessary to examine the level of awareness and its obstacles in the first step. In this regard, one of the most important problems in the intensive care unit is ventilator-associated pneumonia, which is one of the most common hospital infections that occurs 24 hours after tracheal intubation or mechanical ventilation. Purpose: The purpose of this research is to investigate the level of knowledge of intensive care unit nurses about evidence-based guidelines in the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the hospitals of the University of Medical Sciences and Health-Therapeutic Services of Gilan province. Implementation method: This research is a descriptive-analytical cross-sectional study. The sample size is estimated through the census. This research consists of three parts: the first part includes the personal-social information of the participants and the characteristics of the intensive care unit, the second part examines the knowledge of nurses about the evidence-based guiding principles in the prevention of ventilator-associated pneumonia, and the third part examines the obstacles to the implementation of these principles. Results: Out of 219 nurses, 171 (78.08%) participated in this research. The average grade obtained was 4.63. One question from the questionnaire (semi-sitting position) that was answered correctly is the degree of evidence-based guideline proposal, two questions from the questionnaire that most participants answered incorrectly are the period of replacing the ventilator set and the period of replacing the humidifier.  Conclusion: The results show that the mean and standard deviation of nurses' awareness was 4.63 ± 1.708. One questionnaire question received the most correct answers. And two questions from the questionnaire had the most incorrect answers. No significant relationship was found between average knowledge and demographic variables. In the 14 investigated departments, there was no necessary equipment (tracheal tube with suction under the glottis and kinetic bed) to implement evidence-based guidelines.

    Keywords: awareness - special care department - evidence-based nursing - ventilator-associated pneumonia - hospital nursing staff

    1 Introduction:

    Care is considered as an essential component in the field of healthcare services. Nursing care is more important among all the care provided in medical environments such as hospitals (1). The need to use scientific evidence in the nursing profession is increasingly evident. The expansion of this changes the terms used for it, and terms such as evidence-based practice [1] are extracted from evidence-based medicine [2], which, due to necessity, another concept called evidence-based nursing [3] is proposed in nursing (2).

    Saket[4] et al in defining evidence-based care stated that evidence-based care is the application of the best research results along with knowledge and expertise, clinical experiences, and attention to the patient's values. in the provision of care (3). Evidence-based nursing is a process during which a nurse can make appropriate clinical decisions using available research evidence (4). Habibi et al., citing Gibbs [5], also defined evidence-based nursing as prioritizing the patient's interests through clinical decision-making using the best evidence in patient care (5).

    Nahariro colleagues quoted from Rustas [6] stated that the importance of using evidence in practice is the optimal use of a large amount of information in the minimum time, doing things the right way with the best available and efficient standard methods, ensuring the correct performance of care tasks, improving the quality of care by nurses, implementing the best and most correct patient care at the best time to improve the condition and outcome of patients with evidence-based care, increasing patient satisfaction, care with Quality in a supportive environment is accompanied by wise decision-making and a special focus on research evidence in nursing practice beyond care habits and routines (6).

    Many institutions can save time, energy and financial resources by applying evidence-based practice (7). This method has promoted the work of nurses and has replaced doubts in nursing care with certainty (7). Meanwhile, nurses who use evidence and evidence do their work. They are more satisfied, which leads to the improvement of the quality of care. It has also been shown that evidence-based practice increases the probability of students' success in providing nursing programs (8). However, many medical and nursing procedures are based only on traditional processes, assumptions and working assumptions, individual skills and unorganized clinical observations (9). For example, nurses are often taught to inject insulin in a sterile way, but now it is said that diabetic patients can safely inject through clothing (10). Also, today, there is a lot of emphasis on early discharge of patients from the hospital and follow-up at home, and it has been found that this has led to the acceleration of physical recovery in stroke patients (11). But our health system still emphasizes on hospital services (9).

    Clinical guidelines are specifically designed based on the best evidence available in medical centers. Because nurses play an effective role in raising the quality of care, these instructions should be used for nurses in different clinical conditions and all the conditions and situations faced by nurses should be taken into account (12).  Especially in special departments where nurses play an important role in its administration, and providing quality care programs according to standards is more important in these departments (13). For this purpose, it is necessary to apply evidence-based guidelines and review the quality of evidence-based clinical care guidelines in the field of the most common complications in special care units in order to improve care. As a result of the use of ventilators, problems and issues related to evidence-based guidelines arise in the intensive care unit, one of the most important of which is ventilator-associated pneumonia. Ventilator-associated pneumonia (VAP) [7] is one of the hospital infections [8] that occurs in patients undergoing mechanical ventilation with artificial airway placement after 24 hours.

  • Contents & References of Investigating the level of awareness of special care nurses about the evidence-based guidelines for the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the health-treatment centers of the University of Medical Sciences and Health-Treatment Services, Gilan Province, 2013

    List:

    Chapter One: Generalities

    1-1 Introduction: 5

    2-1 Research objectives: 9

    3-1 Research assumptions or questions: 10

    4-1 Theoretical definitions of words: 10

    5-1 Practical definitions of words: 11

    6-1 Presuppositions of research: 11

    7-1 research limitations: 12

    1-2 research framework: 14

    2-2 review of studies. 35

    1-3 types of research. 47

    2-3 research community. 47

    3-3 sampling method. 47

    4-3 Characteristics of research units. 48

    3-5 research environment. 48

    6-3 tools and methods of collecting information. 48

    7-3 Scientific trust or reliability and validity of the tool 49

    8-3 Data analysis method 49

    3-9 Ethical considerations. 50

    1-4 Research findings: 52

    1-5 Discussion and interpretation of research results: 69

    5-2 Final conclusion. 81

    5-3 application of findings 82

    4-5 suggestions for conducting further research based on research findings. 82

    Resources. 84

    Appendixes 87

    Tools.. . 89

    English abstract

    Source:

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Investigating the level of awareness of special care nurses about the evidence-based guidelines for the prevention of ventilator-associated pneumonia and the obstacles to its implementation in the health-treatment centers of the University of Medical Sciences and Health-Treatment Services, Gilan Province, 2013
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