Evidence-Based Nursing to Reduce Adverse Events Regarding Ventilator Associated Pneumonia, Pressure Injuries and Central Line Bloodstream Infection in Intensive Care Unit 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: Education with EBP, This is a pre- and post- quasi-experimental study..
- Who it may be relevant to
- Registry conditions: Ventilator Acquired Pneumonia, Central Line Associated Blood Stream Infections (CLABSI), Pressure Ulcer (PU), Medical Device Related Pressure Ulcer (MDRPU). 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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Official title
Evidence-Based Nursing to Reduce Adverse Events Regarding Ventilator Associated Pneumonia, Pressure Injuries and Central Line Bloodstream Infection in Intensive Care Unit: A Quasi-experimental Study in Bangladesh
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), Pressure Ulcer (PU), Medical Device Related Pressure Ulcer (MDRPU), and Central Line-Associated Bloodstream Infection (CLABSI). VAP, PU, and MDRPU are significant indicators of the quality of care, while CLABSI is a critical marker of healthcare quality in ICUs, as it is largely preventable through strict adherence to infection control protocols. VAP is a lung infection that occurs in patients receiving mechanical ventilation for more than 48 hours. A PU is defined as localized damage to the skin or underlying tissue caused solely by pressure, while MDRPUs may also result from friction or pressure from medical devices or other objects. CLABSI is a severe infection caused by improperly inserted or maintained central venous catheters, which underscores the need for stringent catheter management protocols.
Detailed description
General Objective:
The objective of this study is to evaluate whether implementing EBP and changing nurses' competency (skill, knowledge, practice, and attitude) can reduce ICU adverse events such as VAP, PU, MDRPU, and CLABSI, and improve patient outcomes.
Specific Objectives:
1. To identify insights on perceptions, barriers, and facilitators related to EBP implementation in the ICU setting. 2. To evaluate the effect of EBP training on nurses' competency (skill, knowledge, practice, and attitude) regarding EBP for CLABSI, PU, and MDRPU in an ICU setting. 3. To evaluate the effects of EBP on ICU patient incidence rates of VAP, CLABSI, PU, and MDRPU.
Hypothesis:
H1- Hypothesize that training on EBP and its implementation in ICU settings will improve nurses' competency (Skill, knowledge, practice and attitude).
H2- Hypothesize that implementation of EBP by trained ICU nurses will reduce adverse events-such as VAP, pressure ulcers, medical device-related PU, and CLABSIs-and improve overall patient outcomes.
These research consist of two studies:
1. Evaluating the effect of EBP training on ICU nurses' competency (skill, knowledge, practice, and attitude) regarding EBP for CLABSI, PU, and MDRPU in an ICU setting.
A pre- and post-quasi-experimental study will be conducted over a 16-month period, with a total data collection period of 6 months, to evaluate nurses' competency. The study consists of a recruitment period (1 month), nurses' baseline data collection (1 month), nurses' EBP training with midline data collection (2 months), and nurses' endline data collection during EBP implementation (2 months).
Study nurses will receive EBP training and appropriate equipment for patient management. EBP education and training will be provided with necessary equipment, such as a closed suction catheter, an endotracheal tube, a suction device, and a mouth care brush. In this study, global standard equipment will be used to ensure patient safety. 2. Evaluating the effect of EBP implementation on ICU patient incidence rates of VAP, CLABSI, PU, and MDRPU.
A pre- and post-quasi-experimental design with a non-equivalent control group (Study 1, Phase 1 data used as historical data) will be applied by comparing the rate of adverse events such as VAP, CLABSI, PU, and MDRPU before and after the EBP intervention (2-month baseline data and 2-month intervention data will be collected).
Interventions
- Behavioral Education with EBP
Trial 1: Nurse's EBP training ( VAP, PU, MDRPU, CLABSI management), online lecture, 2 hours lecture and 3 hours skill training for nurses training. Trail 1 we use advanced equipment necessary for EBP implementation for VAP, PU, MDRPU and CLABSI management, and EBP-trained nurses implementation for all this management. - Behavioral This is a pre- and post- quasi-experimental study.
We will use advanced equipment and implement EBP (VAP, PU, MDRPU and CLABSI management) for patients by trained nurses and check the outcome of the patients. We will compare pre and post findings for this study.
Primary outcome measures
- The nurse's skill related to the PU, MDRPU and CLABSI total score measured by the researcher-developed checklist [Time frame: 6 month data collection and total time frame of this study 16 months]
- Incidence rates of PU, MDRPU and CLABSI. [Time frame: 2 month for data collection and total time frame 16 months.]
Secondary outcome measures (7)
- Nurses' knowledge, Attitude and Practice (KAP) related to the PU, MDRPU and CLABSI prevention measured by the researcher-developed scale based on Knowledge of EBP guidelines for the PU, MDRPU and CLABSI prevention scale [Time frame: Total data collection time 6 months within 16 months]
- Rate (number of patients) of each stage of PU and MDRPU [Time frame: Total 2 months]
- Micro-organism link to CLABSI [Time frame: 2 months]
- Incidence and rate of VAP [Time frame: 2 months]
- Mortality and morbidity rate of adverse events [Time frame: 2 months]
- Average length of stay ICU patients [Time frame: 2 months]
- Survival rate of ICU [Time frame: 2 months]
Eligibility criteria
Trial 1 \& 2-
Inclusion criteria
Nurse
- who is a registered nurse in Bangladesh.
- who agrees to participate in this study and the EBP training.
- who will stay at the ICU for 6 months. Patient
- Irrespective of age and sex, participants must be at least 18 years old
- Legal guardian of a patient consent to participation in the study
Exclusion criteria
Nurse
- Who will not directly involve patient care in ICU. Patient
- No exclusion criteria
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
Identifiers
NCT: NCT07299799 · BMRC/NREC/2025-2027/313 · 65313072025 · 24K02733