Effect of Implementing Evidence-based Practice and Nurse's Behavior Change on Quality of Care in Intensive Care Unit: Focus on Ventilator Associated Pneumonia in a Tertiary Hospital in Bangladesh
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: This is a pre- and post- quasi-experimental study., Education with EBP.
- Who it may be relevant to
- Registry conditions: Ventilator Associated Pneumonia (VAP), Evidence Based Practice. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Bangladesh, Japan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Quality of care is crucial for preventing adverse events such as infection in the intensive care units (ICUs). The most common ICU-acquired infections include pneumonia such as ventilator-associated pneumonia (VAP), Central Line Bloodstream Infection (CLABSI), catheter-associated urinary tract in, Medical Device Related Pressure Ulcer (MDRPU) and Pressure Ulcer (PU). This study explores the patient outcome in ICU by examining the causes and prevalence of ICU-acquired infection. The implementation of evidence-based practice (EBP) to reduce infection and change the nurses practice (behavioral changes) to adhere with EBP based on simulation-based training. General objective: To evaluate the effect of EBP by using recent technologies-based equipment to prevent VAP and promote behavior change among nurses for better outcome of the patient in ICU. Specific Objectives: 1. To determine the incidence of adverse events (VAP rate, MDRPU rate, PU rate, CLABSI rate), length of stay and survival rate in ICU. 2. To evaluate the effectiveness of EBP education by changing nurses' behavior and determine its impact on improving patient outcomes in the ICU. 3. To evaluate the effectiveness of EBP including proper equipment use and changed nurses behavior acquired through the training for better patient outcome (VAP ratio) in the ICU. 4. To examine the feasibility of evaluation process and outcomes and successful implementation of EBP in ICU. Hypothesis: It is hypothesize that implementing EBP in ICU, including new equipment use and nurses training, will improve patient outcome. These research consist of three studies: Phase 1: Incidence of adverse events (VAP rate, MDRPU rate, PU rate, CLABSI rate), length of stay and survival rate in ICU. The patients of General ICU will be followed up after admission up to discharge or death at ICU. The investigators use the study findings for our subsequent intervention study 3 as historical data. Phase 2: A pre- and post- quasi-experimental study will be conducted for 6 months to evaluate the nurse's competency on EBP after getting 1-month EBP training. This study has 3 steps: (1) Pre-observation period to measure nurse's competency level for 2-month, (2) nurse's EBP training period with preparation for 1 month, and (3) post-implementation period to measure nurse's competency and implementation of EBP practice for 2 months. Study nurses will receive EBP training, EBP and proper equipment for patient management. The nurses will receive EBP education and training with necessary equipment, such as a close suction catheter, an endotracheal tube, a suction device, and a mouth care brush. In this study, use global standard equipment for the patients safety. Phase 3: A pre- and post- quasi-experimental study will be implemented to evaluate the efficacy of EBP implementation. The investigators use new equipment and implement EBP for patients and assess the patient outcomes. The investigators compare the findings from study 1 (as historical data) with the data from this study 3. The investigators will compare the VAP infection prevalence and patients' outcomes related to ICU-acquired infection between pre- and post- test phase.
Interventions
- Behavioral This is a pre- and post- quasi-experimental study.
We will use new equipment and implement EBP (VAP management) for patients by trained nurses (Phase 2) and check the outcome of the patients. We will compare our phase 1 findings for this study as historical data. - Behavioral Education with EBP
Phase 2: Nurse's EBP training ( VAP management), 2 hours lecture and 3 hours skill training for total 4 times in 1 month. Phase 3: Introduce new equipment necessary for EBP implementation for VAP management, and EBP-trained nurses implementation for VAP management.
Primary outcome measures
- The nurse's skill performance is related to VAP checklist [Time frame: Study 2: 6 months]
- Incidence rate of ventilator-associated pneumonia (VAP) [Time frame: 2 months]
Secondary outcome measures (11)
- A nurse's motivation level will be measured [Time frame: 6 month]
- Nurses' sustained implementation measured [Time frame: 6 months]
- Organizational readiness measured [Time frame: 6 months]
- Nurses knowledge and practice related to VAP prevention measured. [Time frame: 6 months]
- VAP episode [Time frame: 2 months]
- Interval of VAP occurrence [Time frame: 2 months]
- Micro-organism link to VAP [Time frame: 2 months]
- Mortality and morbidity rate [Time frame: 2 months]
- Onset of VAP [Time frame: 2 months]
- Length of stay ICU patients [Time frame: 2 months]
- Survival rate in ICU [Time frame: 2 months]
Eligibility criteria
Study 2:
Inclusion criteria
- Who will be a registered nurse in Bangladesh.
- Who will agree to participate in this study and the EBP training.
Exclusion criteria
- Who will not directly involve patient care in ICU.
Study 3:
Inclusion criteria
- Irrespective of age and sex, participant must be 18 years old.
- Legal guardian of a patient consents to participation in the study
- Intubated patients after admission.
Exclusion criteria
- Who stays less than 2 days at the GICU.
- Who dies or is extubated within 2 days after admitted in the GICU.
- ICU readmission.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
Bangladesh · 1 center
- Dhaka Medical College Hospital — Dhaka
Japan · 1 center
- Hiroshima University — Hiroshima
Publications
- Akhter N, Zhou X, Elhabashy S, Huq KATME, Okamoto M, Latif MA, Babaita AO, Moriyama M. Effect of evidence-based education program with mentoring system for prevention of ventilator-associated pneumonia on nurses' competency to improve quality care for patients in the intensive care unit: a quasi-experimental study in a tertiary hospital in Bangladesh. Front Public Health. 2026 Jan 9;13:1674223. do PMID 41584199
Identifiers
NCT: NCT06624540 · BMRC/NREC/2022-2025/338 · 584 19 05 2024 · 24K02733