Introduction
Sedwick, Lance-Smith, Reeder, and Nardi’s (2012) main apprehension was the increasing rate of Ventilator-Associated Pneumonia (VAP) in critical care patients. Ventilator-associated pneumonia is currently becoming one of the common complications among the Healthcare-Associated Infections (HAI) not only within the United States but also around the world. Therefore, VAP is becoming a significant issue among critical care nurses. The authors of this article argue that there is a need for strategies that would aid in the prevention of VAP. The researchers’ main purpose was to determine whether strict observance of the ventilator bundles increases the results of the critical care patients. According to the researchers, adherence to the ventilator bundles reduces the rate of VAP by over 9.5%. In addition, the reduced rate also contributes to reasonable savings in the cost of care given to the patients. In essence, the researchers tended to answer the question of whether adherence to the ventilator bundles could lead to a reduced rate of VAP.
Sedwick, Lance-Smith, Reeder, and Nardi (2012) conducted the study for twelve months within the ICUs of one of the main hospitals. In their study, the researchers audited 4709 ventilator days. The study was designed in such a way that the process of reducing the VAP in ICU began in the previous year. The interdisciplinary specialists were trained on the various aspects of the ventilator bundles and the applications. The data was collected and audited by the compliance audits. This study hypothesizes that strict adherence to the ventilator bundles has a direct correlation with improved patient outcomes. Conversely, the null hypothesis is that strict adherence to the ventilator bundles has no direct correlation with improved patient outcomes.
The findings indicate that strict adherence to the ventilator bundles has the capability of reducing the rate of VAP. In other words, the results indicate that strict adherence to the ventilator bundles is one way through which ventilator-associated pneumonia can be prevented and reduced. According to the study, strict adherences that involve increased accountability among the critical care nurses, application of feedback system as well as interdisciplinary collaboration have a direct correlation with the enhanced patient results and end up in remarkable savings in terms of the costs involved in the patient care.
Research methodology and the critical evaluation of the study
The research design and methodology used to provide the results are not comprehensive. The reviewed literature did not capture the topic to ascertain the claims of the researchers. In essence, the researchers did not give due attention to the importance of secondary information. In any study, secondary data is an important aspect and should not be ignored. The reviewed literature in interrelated studies presents a deeper understanding of the area being studied as well as what other researchers have found on the examined topic. The scrutiny of such literature is helpful in offering novel and comprehensible models that tend to give an explanation of the changes in the area of study, arrange the main concerns, build upon operational explanations and improve on the final research design. On the contrary, the authors of the article provided a briefly reviewed literature of the topic based on a few peer-reviewed articles. Even though the study was designed to be purely quantitative, the qualitative aspect is also critical in determining the study outcomes.
Though the topic being studied is based on the current health issue, it has been studied over time. The reduction of VAP is an area that has been studied for some time. In fact, the ventilator bundles to reduce VAP that the researchers were studying their adherence were established a decade ago. Even though the aspect of the ventilator bundle being studied is novel in this field, currently, it is not one of the pressing issues in the field. However, it is one of the evidence-based practices, which is the major current issue in nursing. In spite of the study’s shortcomings, the study is significant in ascertaining the importance of adhering to the ventilator bundles in the reduction of VAP. Further, the findings of the study are also important in helping critical care nurses understand the significance of ventilator bundle adherence.
The researchers applied the quasi-experimental design to establish the correlation between the adherence to the ventilator bundle and the reduction of VAP. In addition, the researchers, to determine the strength of their purported hypothesis, applied the quasi-experimental design. In the study, the variables were qualitative, nevertheless, the researchers came up with ways through which the data can be quantified and tested. Further, the variables were tested through the application of a compliance feedback tool. The compliance audit was applied to provide immediate feedback.
The research design methodology that was purely quantitative, aimed at testing the validity and consistency of significant characteristics of the research in order to determine the existing correlation. The research participants that consisted of the interdisciplinary specialists were chosen through the unsystematic sampling process. In fact, the random sampling procedure that the researchers applied have been proved to be the best method to select the study participants since there is no indication of any business. All through the study, the researchers made sure that they adhere to the rules and guidelines of the study. In addition, they ensured that they tested their research instruments before embarking on the actual survey.
Besides the sample being unbiased, the researchers were certain that the sample chosen was representative. In fact, the sample was drawn majorly from one hospital though the study was conducted over a long period. The sample was also drawn from various specialists involved in the critical care units. As such, the sample captured the practices and the views of the specialists being studied on a wider scale.
Though the study seems to provide a comprehensive conclusion, there is still an existing gap that needs further research. In particular, the studies need to ascertain the results of the study using a greater sample. The study findings do not provide enough information to adapt the results into the critical care nursing practice. Further, similar findings are needed to support the results of the study.
The researchers were clear and consistent in their communication skills which make the article more understandable. However, in some items such as the results, the information has been made complex by some ambiguity of graphs used. Moreover, the information in the discussion and results are ambiguous such that the difference could not be established.
Though the researchers claim that their findings support the application of evidence-based care in the reduction of VAP, more studies need to be conducted in this area. The studies so far conducted have not fully developed the relationship between adherence to evidence-based care and the reduction of the VAP to be applied in critical care nursing. Since the research methodology applied in this study was limited in some areas, further studies need to be conducted using appropriate methodology and larger samples from various hospitals to ascertain the results (Sedwick et al, 2012). Moreover, further studies are needed to establish new items considered important in the VAP bundles. Despite these shortcomings, the study is quite practicable. The reason is that the study provides a confirmation of the applicability of the VAP bundles, particularly where there is strict adherence. In addition, strict adherence to the VAP bundles by critical care nurses will reduce VAP among critical care patients considerably.
The researchers should have included diversified critical care specialists from various hospitals. Moreover, the specialists could have not been conditioned to provide unbiased views. Further, the study could have shown diversity in samples as well as views (Sedwick et al, 2012). Nevertheless, the results indicated a strong correlation between adherence to the ventilator bundles and the reduction of the VAP.
Conclusion
Though the study had various shortcomings, the results indicate the expected outcomes. The results are in line with the study hypothesis that strict adherence to the ventilator bundles has a direct correlation with improved patient outcomes. The research results are in line with the predictions of the previous empirical and theoretical studies. According to the study, through the application of evidence-based practices, patient morbidity, mortality as well as the cost of healthcare is improved. Moreover, the study indicates that the improved accountability by the critical care nurses on their daily patient care is significant in the improvement of the patient results.
Reference
Sedwick, M. B., Lance-Smith, M., Reeder, S. J. & Nardi, J. (2012). Using Evidence-Based Practice to Prevent Ventilator-Associated Pneumonia. Critical Care Nurse, 32(4), 41-52.