Knowledge, practice and associated factors of the ventilator care bundle approach among Nurses working in Intensive Care Units of Public Hospitals, Addis Ababa, Ethiopia, 2022

Abstract

ABSTRACT Background: Implementation of ventilator care bundles is associated with reductions in ventilator-associated pneumonia. Ventilator care bundle application among nurses, scarcely studied in Addis so far despite of having significant impact when it comes to cost of care, morbidity, mortality, duration of ventilation and length of stay. Objectives: To assess knowledge, practice and associated factors of the ventilator care bundle approach among Nurses working in the intensive care units of public hospital Addis Ababa, Ethiopia, from Dec 15, 2021 to Jan 15, 2022. Methods: An institution based cross-sectional study was conducted from Dec15 to Jan 15, 2022. 201 intensive care unit nurses are included in the study and subjects selected by using complete census method. Data was collected using structured self-administered questionnaires and observation checklists, coded and entered to Epi-info V7 and exported to SPSS V25 for analysis. Descriptive statistics used to describe the variables in the study. Binary Logistic regression model (p<0.25) fitted to identify factors associated with knowledge and practice of ventilator care bundle was expressed in odds ratio with 95% CI and (p<0.05) used as a cut-off point to declare statistically significance in the final model. Model fitness was checked using Hosmer Lemeshow goodness of fit test having p-value<0.085. All assumption of normality test was checked. Result: Among 201 ICU study population, 190 participants were involved with 94.5% response rate. From a total, 123(64.7%) of the participants had good knowledge and 67(35.3%) had poor knowledge about ventilator care bundle approach. Whereas, among a total, 70(36.8%) of the participants had good practice and 120(63.2%) had poor practice. ICU nurses who had training on Mechanical ventilation (AOR=1.8(95% CI: 1.2, 3.35), training on intensive care unit (AOR=2.6(95% CI: 1.4, 4.8) and years of ICU experience (AOR=1.2(95% CI: 0.3, 0.9) were significantly associated with their knowledge level. Nurses who get ICU training (AOR=3.38(95% CI: 1.76, 6.48) and ever cared VAP patient (AOR=2.67(95% CI: 1.16, 6.14) was significantly associated with practice of ICU nurses about ventilator care bundle approach. Conclusion and Recommendation: Based the finding practice on ventilator care bundle approach was poor. Years of ICU experience, ever cared VAP patient, training on mechanical ventilation and intensive care unit were significantly associated with knowledge and practice on bundle care. So continuous training on bundle care has significant impact to improve practice of ventilator care bundle. Key word: Knowledge, practice, ventilator care bundle, ventilator associated pneumonia