Study On The Status And Influencing Factors Of Oral Care To Prevent Ventilator Associated Pneumonia Of ICU Nurses

Objectives:The study is to investigate knowledge-attitude-practice level with the oral care to prevent ventilator associated pneumonia of nurses in tertiary hospitals of shandong province.In order to understand difficulties that may be encountered by ICU nurses in clinical work for endotracheal intubation patients and to provide theoretical basis for training education.Influential factors and correlation about knowledge-attidute-practice with oral care to prevent ventilator associated pneumonia were analyzed.Our goal is to provide the high quality of oral care for patients with tracheal intubation through improving ICU nurses behavior compliance.Methods:240ICU nurses randomly sample were selected and the questionaire was used to collect data in September2013to October.The questionaire included the demographic characteristics of ICU nurses, education training status quo,methods of oral care with tracheal intubation patients,knowledge-attitude-behavior status of oral care to prevent ventilator associated pneumonia,it was a total of three dimensions and28entries. Epidata3.1software was used to establish the database, use SPSS17.0software package for statistical analysis.The statistical methods include descriptive statistical analysis, t-test, single factor analysis of variance, pearson correlation analysis, multiple linear regression analysis. Results:1. The full scores of oral care to prevent VAP for ICU nurses that related knowledge-attitude-practice were respectively24,30,30. The total average scores of respondents that related knowledge-attitude-practice were respectively22.46±1.97,22.56±3.42and26.90±2.11.2. There are positive correlations for respondents to prevention of ventilator associat-ed pneumonia with oral care according to knowledge-attitude-behavior,The correlation coefficient respectively was0.17,0.44,0.15, the difference was statistically significant (P<0.01).3. Single factor analysis showed that there was a remarkable difference (P<0.01) in different departments of ICU nurses for having effect on the score of knowledge-attitude-practice.The score was statistically difference for different education degree and number of training of ICU nurses as regards oral care to preventing VAP knowledge (P<0.05), Different working experience of ICU nurses about oral care to prevent VAP attitude-behavior score was statistically difference (P<0.05)4. According to multiple liner stepwise regression analysis, the working experiences and ICU working times into knowledge regression equation,which could explain47percent of variations of knowledge full score. Department and economic income into attitude regression equation,which could explain14percent of variations of attitude full score.Department and age into practice regression equation which could explain11percent of variations of practice full score.5. The methods of oral care are choosen usually for patients with tracheal intubation by respondents.More than a third of ICU nurses choose0.9%Nacl cotton swab to wipe;11.7percent and13percent of ICU nurses choose0.12%chlorhexidine wash for oral intubation and tracheostomy patients.Whereas no nurse choose0.12%chlorhexidine rinse for patients with nasal intubation; Only5percent of the nurses choose electric toothbrush.6. The main causes were that respondents didn’t think you can provide oral care for patients with tracheal intubation: they didn’t have enough hours for patients with oral care and plenty of nursing staff; moreover, fear of patients condition change. 7.20.8percent of ICU nurses did not participate in training, The main way to acquire knowledge for respondents was education training(85.6%), network(15.2%) communicate with others(15.2%),books and magazines(7.0%). The main training methods included lectures(80%),meeting(40.4%) and on-site operation training (39.6%).Conclusion:1. Through the survey,we found that ICU nurses were lack of knowledge of oral care to prevent VAP. However,their attitude and behavior should be further improved. ICU nurses who were short of critical mind continue to use the old ways of oral care2. The better ICU nurses grasp knowledge of oral care to prevent VAP, attitude is positive, the better behavior of the oral care to prevent VAP compliance.3. The influential factors of knowledge-attitude-behavior for oral care to preventing ventilator associated pneumonia respectively were working experiences,ICU working times,department, economic income and age.4. The compliance of ICU nurses oral care to preventing VAP were influence by many factors.It relied on comprehensive measures taken by department management, such as human resource allocation, personal effort and the attention of the hospitals.While improved the knowledge, attitude, behavior, hospital managers should equip with advanced oral care to the ICU.5. At present, theory and practice courses are suitable for clinical education training. However, the survey found that more than1/5of the nurses didn’t attend the VAP training,2/5of the nurses who participate in VAP training only have site operation training experience. Hospital and department managers should establish a unified, standardized training, on-site operation training. Only hospital and department managers should establish a unified, standardized training standards, and strengthen clinical through training, pay attention to training effect. The ICU nurses are able to set up the firm belief and improve their behavior compliance.