Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients

Abstract: Objective: We evaluated the impact of an experiential learning strategy on both the adherence to the use of bundles and the incidence of ventilator-associated pneumonia in critically ill adult patients. Methods: Longitudinal, quasi-experimental interrupted time-series study in a tertiary...

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Autores principales: Michelángelo, Hernán, Angriman, Federico, Pizarro, Rodolfo, Bauque, Susana, Kecskes, Claudia, Staneloni, inés, García, David, Espínola, Fidencia, Mazer, Gustavo, Ferrari, Cristina
Formato: Artículo
Lenguaje:Inglés
Publicado: SAGE Publications 2020
Materias:
ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
Acceso en línea:https://repositorio.uca.edu.ar/handle/123456789/9810
Aporte de:
Repositorio Institucional de la Universidad Católica Argentina (UCA) de Universidad Católica Argentina
id I33-R139123456789-9810
record_format dspace
institution Universidad Católica Argentina
institution_str I-33
repository_str R-139
collection Repositorio Institucional de la Universidad Católica Argentina (UCA)
language Inglés
topic ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
spellingShingle ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
Michelángelo, Hernán
Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
topic_facet ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
description Abstract: Objective: We evaluated the impact of an experiential learning strategy on both the adherence to the use of bundles and the incidence of ventilator-associated pneumonia in critically ill adult patients. Methods: Longitudinal, quasi-experimental interrupted time-series study in a tertiary teaching hospital in Buenos Aires, Argentina. Successive measurements were made before and after the intervention was implemented between January 2016 and December 2018. Our main exposure was experiential learning, which was based on a combination of play activities, simulation models, knowledge and attitude competencies, role-playing and feedback. The adherence to the bundle for the care of mechanically ventilated critically-ill adult patients and the occurrence of ventilator-associated pneumonia were the main outcomes of interest. We used generalized linear models including time as a linear spline to estimate the effect of the experiential learning strategy both on the adherence to the bundle of care and the occurrence of ventilator-associated pneumonia during long-term follow-up. Results: The overall proportion of adequate bundle use before and after the implementation of the intervention was 60.8% (95% CI: 56.9–64.7) and 85.6% (95% CI: 81.2–90.1), respectively. The incidence rate of ventilator-associated pneumonia before and after the intervention was 6.11 (95% CI: 5.82–6.40) and 3.55 (95% CI: 2.96–4.14) every 1000 days of mechanical ventilation, respectively. The estimated baseline monthly change in the adherence to the mechanical ventilation bundle was 0.4% (95%CI: 0.3–1.2%, p ¼ 0.31) and 1.1% (95% CI: 0.2–2.2%, p < 0.01) before and after the implementation of the intervention, respectively. These results were consistent across our statistical quality control analysis. Conclusions: The implementation of experiential learning strategies improves the adherence to bundles in the care of mechanically ventilated critically ill adult patients. Such strategies also decrease the incidence rate of ventilator-associated pneumonia. Both effects appear to remain constant during long-term follow-up.
format Artículo
author Michelángelo, Hernán
Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
author_facet Michelángelo, Hernán
Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
author_sort Michelángelo, Hernán
title Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_short Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_full Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_fullStr Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_full_unstemmed Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_sort implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
publisher SAGE Publications
publishDate 2020
url https://repositorio.uca.edu.ar/handle/123456789/9810
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