Ventilator-associated pneumonia
Conditions
Interventions
Group 1: Patients requiring mechanical ventilation in the intensive care unit who meet the inclusion criteria are cared for by the nursing competence team (RT & APN) as part of mechanical ventilation.
Sponsors
Herz- und Diabeteszentrum NRW
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients: - Elective admission - Thoracic and/or cardiovascular surgical intervention - German language - Postoperative stay in an intensive care unit with > 3 days and mechanical ventilation - Documented and practical specialist care by the RT and APN competence team Additionally in study phase II: Informed consent for the follow-up Focus group interview: - Exercise of a patient-related activity as nursing, medical and physiotherapy service - If applicable, involvement of other professional groups that carry out patient-related activities in the ICUs (e.g. speech therapy service) - Informed consent Patient and Public Involvement (PPI) und Advisory Board: • Patients • Persons from medical and nursing associations and the NRW Chamber of Nursing; with expertise in the respective specialist practice and/or research • Informed consent
Exclusion criteria
Exclusion criteria: - Emergency admission - No thoracic and/or cardiovascular surgical intervention - Age on admission <18 years - Insufficient command of the German language - Postoperative stay in an intensive care unit of < 3 days or no mechanical ventilation - Proven SARS-CoV2 infection - No care provided by the RT and APN competence team Additionally in study phase II: Lack of informed consent in the follow-up survey Focus group interview: - Age at the start of the focus group interview of <18 years - Exercise of an activity remote from the patient - Lack of informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Phase I: Inhibiting and promoting factors of implementation Phase II: Recruitment rate and delivery rate | — |
Secondary
| Measure | Time frame |
|---|---|
| Phase I: - Task profile of the nursing competence team (ongoing monitoring) - Number, characteristics and clinical pictures of patients receiving care (ongoing monitoring) Patient and Public Involvement (PPI) and Advisory Board: Within a PPI and Advisory Board (online), the role profile developed to date for RT and APN is to be presented, discussed and, if necessary, modified. Phase II: - Total duration of invasive and/or non-invasive ventilation (NIV) in minutes (read from the electronic patient file) - Total length of stay in the ICU in days (readout from the electronic patient file) - Mortality (readout from the electronic patient file) - Frequency and duration of mobilization measures (readout from the patient file) - Delirium incidence and delirium duration, measured in 8-hour blocks using the Confusion Assessment Method for Intensive Care Units (CAM-ICU; readout from the electronic patient file) - Pain intensity (10-point NRS from 0 [no pain] to 10 [maximum imaginable pain] or, if communication is not possible, measured in 8-hour blocks using the Critical Care Pain Observation Tool [CPOT]) - Anxiety (10-point Numerical Rating Scale [NRS] from 0 [no anxiety] to 10 [maximum imaginable anxiety] measured in 8h blocks) - Incidence of ventilator-associated pneumonia (VAP): Infection parameters of routine laboratory monitoring: CRP, leukocytes (once daily; readout from the electronic patient file) as well as coded pneumonia and weaning forms - Complications in the context of ventilation (after implementation, readout from the patient file) - Intervention costs of the AT and APN competence team (after implementation, readout of the interventions from the patient file and from the duty rosters) - Effects on the multiprofessional team (focus group interviews) - Inhibiting and promoting factors of implementation (focus group interviews) | — |
Countries
Germany
Contacts
Public ContactLars Krüger; Franziska Wefer
Herz- und Diabeteszentrum NRW
Outcome results
None listed