Effective Implementation of Ventilator Care Bundles in Improves Outcomes: A Multicenter Randomized Controlled Clinical Trial

Abstract

OBJECTIVES: To evaluate the effect of 17-ventilator care bundles and different training strategies for critical care nurses on clinical outcomes. DESIGN: A randomized controlled triple-blinded clinical trial. SETTING: The multicenter study was conducted in four academic teaching hospitals in Tehran, Iran, from October 2011 to June 2015. PATIENTS: A total of 1,600 adult patients (age ≥ 18 yr) who were admitted to mixed medical-surgical ICUs (> 72 hr) and received invasive ventilation (> 48 hr) were included in this study. In addition, 160 critical care nurses were recruited through letters and telephone and face-to-face invitations. INTERVENTIONS: Seventeen-ventilator care bundles applied by four different groups of nurses. MEASUREMENTS AND MAIN RESULTS: Clinical outcomes were compared between four groups of study which include three intervention groups (who received 17-ventilator care bundles by trained nurses) and one control group (who received routine care). According to the results, ICU length of stay, non-ICU length of stay, ventilator-associated pneumonia occurrence date, ventilator-associated pneumonia, and mortality rates were significantly higher in control group compared with other groups. CONCLUSIONS: Critical care nurses training program to accurately implement 17-ventilator care bundles improves outcomes.