The Relationship Between Nurses Workload and Compliance with the Implementation of the Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit
Abstract
The latest data shows an increase of 35% in the case of Ventilator-Associated Pneumonia (VAP). The incidence of VAP in the intensive care unit can be minimized with a bundle of VAP. The success of the bundle VAP can be achieved through compliance in maintenance. The nursing profession tends to have a high workload, which can have a negative impact on patient care. This study aims to identify the relationship between the nurses' workload and compliance with the implementation of the Bundle VAP in the intensive care unit. This research method uses a quantitative approach with cross-sectional designs. The sampling technique uses a total sampling with a total sample of 38 intensive room nurses. The data collection method in this research is an online questionnaire consisting of the NASA-TLX questionnaire and the VAP bundle implementation compliance questionnaire. The results of Chi Square's analysis showed a significant relationship between the nurse's workload and compliance with the implementation of the Bundle VAP in the intensive care unit with a sig. Value of 0.000 (P<0.05). Nurses with a high workload have a higher risk of not complying with the implementation of the VAP bundle than nurses with a medium workload. Efforts are needed to improve the VAP prevention training program, provide education for managing workloads, and create a strong teamwork culture.
References
Abdelrazik, A., Salah, A., 2017. Ventilator-associated pneumonia in adult intensive care unit prevalence and complications. The Egyptian Journal of Critical Care Medicine 5, 61–63.
Achmad, F., Farihah, T., 2018. Analisa Beban Kerja Mental Menggunakan Metode Nasa Task Load Index (NASA-TLX). Integrated Lab Journal 6, 29–36. https://doi.org/10.5281/zenodo.1993970
Akdogan, O., Ersoy, Y., Kuzucu, C., Gedik, E., Togal, T., Yetkin, F., 2017. Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle that contains endotracheal tube with subglottic drainage and cuff pressure monitorization. Brazilian Journal of Infectious Diseases 21, 276–281. https://doi.org/10.1016/j.bjid.2017.01.002
Aliftitah, S., Mumpuningtias, E.D., Muttaqin, I., 2018. Hubungan Beban Kerja Dengan Stres Kerja Pada Perawat Di Ruang ICU RSUD Dr. H. Moh. Anwar Sumenep. Jurnal Kesehatan “Wiraraja Medika” 8, 34–42. https://doi.org/https://doi.org/10.24929/fik.v8i2.650
American Association of Critical-Care Nurses, 2015. AACN Scope and Standards for Acute and Critical Care Nursing Practice. American Association of Critical-Care Nurse
Aryani, D.F., Durhayati, Y., 2018. Gambaran Tingkat Kepatuhan dan Faktor-Faktor yang Memengaruhi Kepatuhan Perawat dalam Penerapan Bundle Ventilator Associated Pneumonia. Jurnal Riset Kesehatan Nasional 2, 149-157.
Bankanie, V., Outwater, A.H., Wan, L., Yinglan, L., 2021. Assessment of knowledge and compliance to evidence-based guidelines for VAP prevention among ICU nurses in Tanzania. BMC Nurs 20, 1–12. https://doi.org/10.1186/s12912-021-00735-8
CDC, 2021. Healthcare-associated Infections (HAI) [WWW Document]. Centers for Disease Control and Prevention. URL https://www.cdc.gov/hai/data/portal/index.html (accessed 3.24.22).
Ghosh, U.K., Hossain, M.M., Shirin, M., Hoque, M.S., Sonia, S.F., Islam, T., 2019. Predictors of Ventilator Associated Pneumonia of Neonate in a Neonatal and Paediatric Intensive Care Unit. Bangladesh Journal of Child Health 43, 90–96. https://doi.org/10.3329/bjch.v43i2.42552
Hoonakker, P., Carayon, P., Gurses, A.P., Brown, R., Khunlertkit, A., McGuire, K., Walker, J.M., 2011. Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX). IIE Trans Healthc Syst Eng 1, 131–143. https://doi.org/10.1080/19488300.2011.609524
Jam, R., Hernández, O., Mesquida, J., Turégano, C., Carrillo, E., Pedragosa, R., Gómez, V., Martí, L., Vallés, J., Delgado-Hito, P., 2017. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study. Enfermería Intensiva (English ed.) 28, 178–186. https://doi.org/10.1016/j.enfie.2017.10.002
Jansson, M., Ala-Kokko, T., Ylipalosaari, P., Syrjälä, H., Kyngäs, H., 2013. Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated
pneumonia - A survey study. Intensive Crit Care Nurs 29, 216–227. https://doi.org/10.1016/j.iccn.2013.02.006
Kaslam, P., Widodo, D., Satari, H.I., Karuniawati, A., Kurniawan, L., 2021. Buku Pedoman Pencegahan Pengendalian Infeksi. UI Publishing, Jakarta.
Moghadam, K.N., Chehrzad, M.M., Masouleh, S.R., Mardani, A., Maleki, M., Akhlaghi, E., Harding, C., 2020. Nursing workload in intensive care units and the influence of patient and nurse characteristics. Nurs Crit Care 26, 425–431. https://doi.org/10.1111/nicc.12548
Nasirizad Moghadam, K., Chehrzad, M.M., Reza Masouleh, S., Maleki, M., Mardani, A., Atharyan, S., Harding, C., 2021. Nursing physical workload and mental workload in intensive care units: Are they related? Nurs Open 8, 1625–1633. https://doi.org/10.1002/nop2.785
Nuryani, E., Dwiantoro, L., Nurmalia, D., 2021. Faktor-faktor yang meningkatkan kepatuhan perawat dalam penerapan prinsip enam benar pemberian obat. Jurnal Kepemimpinan dan Manajemen Keperawatan 4. https://doi.org/10.32584/jkmk.v4i1.572
Papazian, L., Klompas, M., Luyt, C.E., 2020. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med 46, 888–906. https://doi.org/10.1007/s00134-020-05980-0
Pepin, B.J., Lesslie, D., Berg, W., Spaulding, A.B., Pokora, T., Harris-Haman, P.A., Zukowsky, K., 2019. ZAP-VAP: A Quality Improvement Initiative to Decrease Ventilator-Associated Pneumonia in the Neonatal Intensive Care Unit, 2012-2016. Advances in Neonatal Care 19, 253–261. https://doi.org/10.1097/ANC.0000000000000635
Resar, R., Pronovost, P., Haraden, C., Simmonds, T., Rainey, T., Nolan, T., 2005. Using a Bundle Approach to Improve Ventilator Care Processes and Reduce Ventilator-Associated Pneumonia. The Joint Commission Journal on Quality and Patient Safety 32, 243–248.
Sadli, M.F., Tavianto, D., Redjeki, I.S., 2017. Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif 5, 85. https://doi.org/10.15851/jap.v5n2.1108
Saodah, S., 2019. Knowledge of Guideline VAP Bundle Improves Nurse Compliance Levels in Preventing Associated Pneumonia (VAP) Ventilation in the Intensive Care Unit. Media Keperawatan Indonesia 2, 113. https://doi.org/10.26714/mki.2.3.2019.113-120
Solikin, Adi, M.S., Arso, S.P., 2021. Analisis faktor-faktor yang mempengaruhi kepatuhan mengikuti pedoman perawatan Bundle Ventilator Associated Pneumonia ( VAP ) 15, 430–442.
Tabaeian, S., Yazdannik, A., Abbasi, S., 2017. Compliance with the standards for prevention of ventilator-associated pneumonia by nurses in the intensive care units. Iran J Nurs Midwifery Res 22, 31–36. https://doi.org/10.4103/1735-9066.202073
Tubbs-cooley, H.L., Mara, C.A., Carle, A.C., Gurses, A.P., 2018. Intensive & Critical Care Nursing The NASA Task Load Index as a measure of overall workload among neonatal , paediatric and adult intensive care nurses. Intensive Crit Care Nurs 1–6. https://doi.org/10.1016/j.iccn.2018.01.004
Umansky, J., Rantanen, E., 2016. Workload in nursing. Proceedings of the Human Factors and Ergonomics Society 551–555. https://doi.org/10.1177/1541931213601127
Widegdo, H., Marti, E., Ratnawati, E., 2022. Hubungan antara beban kerja dengan kepatuhan perawat dalam pendokumentasian Early Warning System (EWS) di ruang rawat Inap Rumah Sakit Panti Rahayu Gunung Kidul. Jurnal keperawatan I Care 3, 137–145.
Xu, Y., Lai, C., Xu, G., Meng, W., Zhang, J., Hou, H., Pi, H., 2019. Risk factors of ventilator-associated pneumonia in elderly patients receiving mechanical ventilation. Clin Interv Aging 14, 1027–1038.
Zubair, S., Ali, H., Zafar, F., Beg, A., Sial, A., Naveed, S., 2017. Ventilator-associated pneumonia (VAP): Clinical strategies, treatment challenges and economic concerns. J Bioequivalence Bioavailab 9, 432–436.
Achmad, F., Farihah, T., 2018. Analisa Beban Kerja Mental Menggunakan Metode Nasa Task Load Index (NASA-TLX). Integrated Lab Journal 6, 29–36. https://doi.org/10.5281/zenodo.1993970
Akdogan, O., Ersoy, Y., Kuzucu, C., Gedik, E., Togal, T., Yetkin, F., 2017. Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle that contains endotracheal tube with subglottic drainage and cuff pressure monitorization. Brazilian Journal of Infectious Diseases 21, 276–281. https://doi.org/10.1016/j.bjid.2017.01.002
Aliftitah, S., Mumpuningtias, E.D., Muttaqin, I., 2018. Hubungan Beban Kerja Dengan Stres Kerja Pada Perawat Di Ruang ICU RSUD Dr. H. Moh. Anwar Sumenep. Jurnal Kesehatan “Wiraraja Medika” 8, 34–42. https://doi.org/https://doi.org/10.24929/fik.v8i2.650
American Association of Critical-Care Nurses, 2015. AACN Scope and Standards for Acute and Critical Care Nursing Practice. American Association of Critical-Care Nurse
Aryani, D.F., Durhayati, Y., 2018. Gambaran Tingkat Kepatuhan dan Faktor-Faktor yang Memengaruhi Kepatuhan Perawat dalam Penerapan Bundle Ventilator Associated Pneumonia. Jurnal Riset Kesehatan Nasional 2, 149-157.
Bankanie, V., Outwater, A.H., Wan, L., Yinglan, L., 2021. Assessment of knowledge and compliance to evidence-based guidelines for VAP prevention among ICU nurses in Tanzania. BMC Nurs 20, 1–12. https://doi.org/10.1186/s12912-021-00735-8
CDC, 2021. Healthcare-associated Infections (HAI) [WWW Document]. Centers for Disease Control and Prevention. URL https://www.cdc.gov/hai/data/portal/index.html (accessed 3.24.22).
Ghosh, U.K., Hossain, M.M., Shirin, M., Hoque, M.S., Sonia, S.F., Islam, T., 2019. Predictors of Ventilator Associated Pneumonia of Neonate in a Neonatal and Paediatric Intensive Care Unit. Bangladesh Journal of Child Health 43, 90–96. https://doi.org/10.3329/bjch.v43i2.42552
Hoonakker, P., Carayon, P., Gurses, A.P., Brown, R., Khunlertkit, A., McGuire, K., Walker, J.M., 2011. Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX). IIE Trans Healthc Syst Eng 1, 131–143. https://doi.org/10.1080/19488300.2011.609524
Jam, R., Hernández, O., Mesquida, J., Turégano, C., Carrillo, E., Pedragosa, R., Gómez, V., Martí, L., Vallés, J., Delgado-Hito, P., 2017. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study. Enfermería Intensiva (English ed.) 28, 178–186. https://doi.org/10.1016/j.enfie.2017.10.002
Jansson, M., Ala-Kokko, T., Ylipalosaari, P., Syrjälä, H., Kyngäs, H., 2013. Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated
pneumonia - A survey study. Intensive Crit Care Nurs 29, 216–227. https://doi.org/10.1016/j.iccn.2013.02.006
Kaslam, P., Widodo, D., Satari, H.I., Karuniawati, A., Kurniawan, L., 2021. Buku Pedoman Pencegahan Pengendalian Infeksi. UI Publishing, Jakarta.
Moghadam, K.N., Chehrzad, M.M., Masouleh, S.R., Mardani, A., Maleki, M., Akhlaghi, E., Harding, C., 2020. Nursing workload in intensive care units and the influence of patient and nurse characteristics. Nurs Crit Care 26, 425–431. https://doi.org/10.1111/nicc.12548
Nasirizad Moghadam, K., Chehrzad, M.M., Reza Masouleh, S., Maleki, M., Mardani, A., Atharyan, S., Harding, C., 2021. Nursing physical workload and mental workload in intensive care units: Are they related? Nurs Open 8, 1625–1633. https://doi.org/10.1002/nop2.785
Nuryani, E., Dwiantoro, L., Nurmalia, D., 2021. Faktor-faktor yang meningkatkan kepatuhan perawat dalam penerapan prinsip enam benar pemberian obat. Jurnal Kepemimpinan dan Manajemen Keperawatan 4. https://doi.org/10.32584/jkmk.v4i1.572
Papazian, L., Klompas, M., Luyt, C.E., 2020. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med 46, 888–906. https://doi.org/10.1007/s00134-020-05980-0
Pepin, B.J., Lesslie, D., Berg, W., Spaulding, A.B., Pokora, T., Harris-Haman, P.A., Zukowsky, K., 2019. ZAP-VAP: A Quality Improvement Initiative to Decrease Ventilator-Associated Pneumonia in the Neonatal Intensive Care Unit, 2012-2016. Advances in Neonatal Care 19, 253–261. https://doi.org/10.1097/ANC.0000000000000635
Resar, R., Pronovost, P., Haraden, C., Simmonds, T., Rainey, T., Nolan, T., 2005. Using a Bundle Approach to Improve Ventilator Care Processes and Reduce Ventilator-Associated Pneumonia. The Joint Commission Journal on Quality and Patient Safety 32, 243–248.
Sadli, M.F., Tavianto, D., Redjeki, I.S., 2017. Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif 5, 85. https://doi.org/10.15851/jap.v5n2.1108
Saodah, S., 2019. Knowledge of Guideline VAP Bundle Improves Nurse Compliance Levels in Preventing Associated Pneumonia (VAP) Ventilation in the Intensive Care Unit. Media Keperawatan Indonesia 2, 113. https://doi.org/10.26714/mki.2.3.2019.113-120
Solikin, Adi, M.S., Arso, S.P., 2021. Analisis faktor-faktor yang mempengaruhi kepatuhan mengikuti pedoman perawatan Bundle Ventilator Associated Pneumonia ( VAP ) 15, 430–442.
Tabaeian, S., Yazdannik, A., Abbasi, S., 2017. Compliance with the standards for prevention of ventilator-associated pneumonia by nurses in the intensive care units. Iran J Nurs Midwifery Res 22, 31–36. https://doi.org/10.4103/1735-9066.202073
Tubbs-cooley, H.L., Mara, C.A., Carle, A.C., Gurses, A.P., 2018. Intensive & Critical Care Nursing The NASA Task Load Index as a measure of overall workload among neonatal , paediatric and adult intensive care nurses. Intensive Crit Care Nurs 1–6. https://doi.org/10.1016/j.iccn.2018.01.004
Umansky, J., Rantanen, E., 2016. Workload in nursing. Proceedings of the Human Factors and Ergonomics Society 551–555. https://doi.org/10.1177/1541931213601127
Widegdo, H., Marti, E., Ratnawati, E., 2022. Hubungan antara beban kerja dengan kepatuhan perawat dalam pendokumentasian Early Warning System (EWS) di ruang rawat Inap Rumah Sakit Panti Rahayu Gunung Kidul. Jurnal keperawatan I Care 3, 137–145.
Xu, Y., Lai, C., Xu, G., Meng, W., Zhang, J., Hou, H., Pi, H., 2019. Risk factors of ventilator-associated pneumonia in elderly patients receiving mechanical ventilation. Clin Interv Aging 14, 1027–1038.
Zubair, S., Ali, H., Zafar, F., Beg, A., Sial, A., Naveed, S., 2017. Ventilator-associated pneumonia (VAP): Clinical strategies, treatment challenges and economic concerns. J Bioequivalence Bioavailab 9, 432–436.
Published
2024-04-05
How to Cite
SALSABILA, Syifa Putri; ANGGRAENI, Diah Tika.
The Relationship Between Nurses Workload and Compliance with the Implementation of the Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit.
NurseLine Journal, [S.l.], v. 9, n. 1, p. 26-32, apr. 2024.
ISSN 2541-464X.
Available at: <https://jurnal.unej.ac.id/index.php/NLJ/article/view/44877>. Date accessed: 21 nov. 2024.
doi: https://doi.org/10.19184/nlj.v9i1.44877.
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Articles
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