Ventilation bundle compliance in two Australian intensive care units: An observational study.
Auxillia Madhuvu, Ruth Endacott, Virginia Plummer and 1 others
PMID 33268313WHAT IT FOUND
Ventilation bundle compliance was 88.3% over three days, rising from 79.4% on day 3 to 96.7% on day 5.
Ulcer and blood-clot prevention were high; head elevation, sedation interruption and readiness to extubate were lower early.
Key findings
01Overall bundle compliance was 88.3% across the three days, with mean compliance rising from 79.4% on day 3 to 96.7% on day 5.
02Peptic ulcer and DVT prophylaxis were the most adhered elements, with mean compliance 97.6% and 99.6%; peptic ulcer prophylaxis fell from 100% on day 3 to 93.2% on day 5.
03Sedation interruption and readiness to extubate were lowest on day 3, at 60.4% and 55.2%, and rose to 97.3% and 93.2% by day 5.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included 96 patients from two ICUs, so it may not reflect other units. Compliance was judged from documentation, so missing or inaccurate notes may have affected the rates. The study did not measure patient outcomes, so it cannot show that bundle compliance prevented ventilator complications. Only one ICU used chlorhexidine oral care, so that element was not included in combined analysis. The units' current ventilator-associated event prevention policies were not reviewed before data collection. Some patients were extubated before day 5, so not all had three days of records for trend analysis.
Declared interests
Funding was provided by an Australian Government Research Training Program scholarship. The supplied text does not report a competing-interest declaration.
The easy way to misread this
Do not read the 88.3% compliance rate as evidence that the ventilation bundle prevents ventilator complications. The study reviewed documentation from two ICUs and did not examine patient outcomes, so it describes recorded practice, not effectiveness.