Efektivitas VAP Bundle pada Pasien yang Terpasang Ventilasi Mekanik di Ruang Perawatan Intensif: Sebuah Systematic Review

Abstract

Background: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in patients who are attached to a ventilator. VAP prevention should be considered as one of the most important issues in critical care settings and it has become one of the core intensive care units included in one of the assessments of the Joint Commission on Accreditation of Healthcare Organizations. Nurses have a very important role in efforts to prevent VAP. Objective: to identify the effectiveness of the VAP bundle in mechanically ventilated patients in the intensive care unit. Methods: The study was conducted using a systematic review approach. Article search via CINAHL from EBSCOhost, Google Scholar, Medline, PubMed, Cochrane Library, and Proquest using the keywords intensive care unit (ICU), mechanical ventilator (MV), nursing intervention, prevention, ventilator, ventilator associated pneumonia (VAP), ventilator associated pneumonia (VAP) bundles. The inclusion criteria consisted of randomized controlled trials (RCT), quasi-experimental, and observational; available in English; full-text available; year of publication 2009-2019; and specific on the main questions to be the focus of the review. Data were analyzed using Critical Appraisal Tools from JBI (Joanna Briggs Institute). Results: Researchers found 693 articles and only 10 articles included in the review criteria. The VAP bundle is proven to reduce the incidence of VAP, reduce patient mortality, improve patient outcomes, reduce length of stay, and reduce costs of care. Conclusion: Implementation of this VAP bundle requires good teamwork and institutional support. Some of these VAP prevention efforts are closely related to the care that nurses perform every day for patients and this has proven effective in reducing the incidence of VAP.