Table 3 Summary of adherence and barriers to the VAP bundles of care
Item | # Adhered (%) | Barriers | |||||||
|---|---|---|---|---|---|---|---|---|---|
Disagreement with reported trial results | Inadequate resources | Fear of potential adverse effects | Costs | Patient discomfort | Lack of education | Lack of guidelines | Other comments | ||
1. I always comply with the TMC VAP bundle | 58 (96.7) | 1 | 1 | ||||||
2. I interrupt continuous sedative infusions as recommended | 54 (90) | 1 | 2 | 2 | 2 | Not scope of work | |||
3. I adhere to existing oral care protocol | 59 (98.3) | 1 | |||||||
4. I always use chlorhexidine oral rinse as recommended | 57 (95) | 1 | Individualized care | ||||||
5. I always perform subglottic suctioning as recommended | 54 (90) | 1 | 1 | Unavailability and some do not have subglottic suction; not able to suction all | |||||
6. I always use closed suction system for all my patients | 55 (91.7) | 1 | 1 | 1 | 1 | Unavailability | |||
7. I assess the depth of sedation as often as recommended | 57 (95) | ||||||||
8. I interrupt continuous sedative infusions as recommended | 54 (90) | 2 | 2 | ||||||
9. I assess the depth of sedation using a validated tool | 59 (98.3) | Beyond nursing care | |||||||
10. I perform spontaneous breathing test as recommended | 32 (53.3) | 5 | 1 | 5 | Task of RT | ||||
11. I always keep head of bed elevated at 30–45 degrees | 60 (100) | ||||||||
12. I always make sure that mechanical DVT prophylaxis are used as recommended | 48 (80) | 6 | 1 | 1 | 1 | Depends on patient condition | |||
13. I always give pharmacological DVT prophylaxis, as recommended | 45 (75) | Depends on patient condition | |||||||