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Estimated nursing workload for the implementation of ventilator bundles
  1. Westyn Branch-Elliman1,2,
  2. Sharon B Wright1,2,
  3. Jean M Gillis3,4,
  4. Michael D Howell4,5
  1. 1Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2Division of Infection Control/Hospital Epidemiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3Patient Care Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  4. 4Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  5. 5Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Westyn Branch-Elliman, Division of Infectious Disease, Beth Israel Deaconess Medical Center, Mailstop SL-435, Boston, MA 02215, USA; wbranche{at}bidmc.harvard.edu

Abstract

Background Ventilator-associated pneumonia is a common healthcare-associated infection with high attributable morbidity and mortality. Prevention strategies, including prevention bundles, have been widely adopted across the USA. However, the nursing resources required to implement these bundles, and their effect on other aspects of intensive care unit patient care, are unknown.

Methods We conducted a survey of all critical care nurses at our institution to determine the time required, and impact of, a prevention bundle at our hospital.

Results Nurses estimated that the standard ventilator bundle requires a median of 115 min (IQR: 74–182) per patient per day. Although the majority of nurses did not perceive that other patient care tasks were delayed by these prevention activities, this was not universal; 29% (95% CI 21% to 39%) of respondents reported that other patient care tasks were sometimes delayed because time was allocated to ventilator bundle activities.

Conclusions Our estimates may serve as potentially important inputs for cost-effectiveness and decision analyses related to intensive care unit prevention activities. Further research should include direct observations about nursing time allocation related to prevention activities.

  • Critical care
  • Infection control
  • Nosocomial infections
  • Patient safety
  • Quality improvement

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