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Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia.

OBJECTIVE: The purpose of the study was to determine whether an education initiative could decrease the hospital rate of ventilator-associated pneumonia. DESIGN: Pre- and postintervention observational study. SETTING: Five intensive care units in Barnes-Jewish Hospital, an urban teaching hospital. PATIENTS: Patients requiring mechanical ventilation who developed ventilator-associated pneumonia between October 1, 1999, and September 30, 2001. INTERVENTIONS: An education program directed toward respiratory care practitioners and intensive care unit nurses was developed by a multidisciplinary task force to highlight correct practices for the prevention of ventilator-associated pneumonia. The program consisted of a ten-page self-study module on risk factors and practice modifications involved in ventilator-associated pneumonia, inservices at staff meetings, and formal didactic lectures. Each participant was required to take a preintervention test before the study module and identical postintervention tests following completion of the study module. Fact sheets and posters reinforcing the information in the study module were also posted throughout the intensive care units and the Department of Respiratory Care Services. MEASUREMENTS AND MAIN RESULTS: One hundred ninety-one episodes of ventilator-associated pneumonia occurred in 15,094 ventilator days (12.6 per 1,000 ventilator days) in the 12 months before the intervention. Following implementation of the education module, the rate of ventilator-associated pneumonia decreased to 81 episodes in 14,171 ventilator days (5.7 per 1,000 ventilator days), a decrease of 57.6% (p <.001). The estimated cost savings secondary to the decreased rate of ventilator-associated pneumonia for the 12 months following the intervention were between $425,606 and $4.05 million. CONCLUSIONS: A focused education intervention can dramatically decrease the incidence of ventilator-associated pneumonia. Education programs should be more widely employed for infection control in the intensive care unit setting and can lead to substantial decreases in cost and patient morbidity attributed to hospital-acquired infections.

Cost-Benefit Analysis↗

Multimethod teaching modules.

The information in this article is for a wide variety of nurses who find themselves in a teaching role: the critical care nurse orienting another nurse (experienced or new graduate); the critical care manager who needs to present an inservice program; and the educator or clinical specialist looking for a new way to present the same information. The author describes how self-paced modules for inservice education offer variety to learners since learners choose the teaching strategy that best suits their learning styles.

Critical Care↗

Self-learning in critical care: a debate.

The popularity of self-learning is on the rise. Despite its overwhelming appeal, this instructional method also has its shortcomings. The author presents the pros and cons of self-learning and their implications in critical care education.

Critical Care↗

Understanding ventricular assist devices: a self-study guide.

Considerable progress has been made over the past several decades in development of ventricular assist device (VAD) technology. Initially, failure to wean from cardiopulmonary bypass was the primary indication for VAD support. However, VAD role has expanded to include patients with ventricular failure due to myocardial infarction and patients awaiting cardiac transplantation. A greater number of nurses, both in the intensive care and general floors, are required to care for patients supported with VADs. Therefore, a self-study guide was developed to facilitate learning. Heart failure physiology, mechanical device descriptions, patient selection, potential complications, and nursing care of patients who require VAD support are reviewed.

Bandages↗

Management development: preparing nurse managers for the future. Part 1, Program model.

Nurse executives need to develop programs to help nurse managers meet rapidly changing role expectations and prepare for new healthcare challenges. This two-part series reports on one such program for nurse managers at The Johns Hopkins Hospital. Part 1 describes the program model, its conceptual framework, and its various components. Part 2 will present an in-depth evaluation of the program and recommendations for future development.

Baltimore↗

A library instruction module.

The authors describe a modular instruction method to teach nursing students important library skills and provide an example of the instructional module. A pilot study demonstrated the value of this approach in facilitating use of the library. Nurse educators can use this method to assist their students in accessing reference materials quickly and successfully.

Curriculum↗

Teaching the use of data resources.

Reading a client's medical record is a skill that can be taught to nursing students. This is an example of a self-paced module to familiarize students with their textbook and reference books, with what is in the medical record, and with how the nurse uses the medical record.

Clinical Competence↗

Learning--whose responsibility is it?

Nursing programs continue to experience alarmingly high attrition rates. To offset the attrition rate, the author describes a shifting paradigm between the traditional faculty advisor role and the innovative faculty coach role. The new faculty coach role includes teaching at-risk students to use learning and motivational strategies and self-management skills to improve academic success. The author provides readers with successful strategies to improve student retention by developing active learners who take responsibility for their own learning.

Attitude of Health Personnel↗

A remediation process for nursing students at risk for clinical failure.

The authors propose a remediation process for nursing students at risk for clinical failure. The process is embedded within the context of clinical evaluation and includes the use of a learning contract as an integral component. The strengths and limits of the process and suggestions for further development are included.

Attitude of Health Personnel↗