Evaluation of critical care nurse’s adherence to the principles of infection prevention and control when providing respiratory care to ventilated ICU patients.

Ms Natasha Ciampoli3, Mr Stephane Bouchoucha2, Ms Judy Currey2, Mrs Ana Hutchinson1

1Deakin University, Centre for Quality and Patient Safety Research  Epworth HealthCare Partnership, Geelong , Australia,

2Deakin University, Geelong, School of Nursing and Midwifery, and Centre for Quality and Patient Safety Research, Geelong, Australia,

3Deakin University, Geelong. School of Nursing and Midwifery, and Epworth Eastern Intensive Care Unit, Box Hill, Geelong, Box Hill, Australia

 

Introduction:

The Australian Commission on Quality and Safety in Health Care has identified the prevention of nosocomial infection as a priority for care improvement. This study explored critical care nurses’ adherence to the principles of Infection Prevention and Control when providing respiratory care

Methods:

A multiple methods research project was undertaken across four ICUs that involved three components: (1) observation of respiratory care delivery, (2) chart audit and (3) a survey of critical care nurses regarding their current practice.

Results:

Thirty seven patients medical records were examined, 26 episodes of a respiratory care provision observed and 45 critical care nurses completed the survey. Observational data showed that nurses’ adherence to the five moments of hand hygiene was low; only 2(12%) washed their hands once prior to the procedure, often donning plastic gloves instead 15(90%). Four nurses (24%) did not use personal protective equipment such as goggles, and only 6(35%) wore a plastic apron when providing respiratory care.  Five endotracheal extubation procedures were observed, each involving two nurses.  In preparation for extubation all 10 nurses donned non-sterile gloves; 8(80%) wore gowns, 6(60%) wore goggles; and 4(40%) washed their hands. In relation to providing respiratory care to ICU patients, none of the surveyed staff members discussed the importance of IPC.

Conclusions:

Variability in nurses’ adherence to evidence-based practices was found on survey, practice and interview. Measures to assist staff to improve respiratory care to prevent HAI are required, with acknowledgement of high levels of adherence in specific aspects of care.


Biography:

Dr Stéphane Bouchoucha has over 20 years’ experience as a clinician, academic and researcher with a focus on critical care, public health, and infection prevention and control. He is a lecturer in the School of Nursing and Midwifery, Deakin University. Stéphane is part of Deakin University’s Centre for Quality and Patient Safety Research (QPS). His research focus is health behaviours, exercise and stress and the psychosocial factors influencing adherence to guidelines in the context of infection prevention and control. Stéphane supervises masters and doctoral projects in a range of areas including critical care and infection prevention.