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Título : Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
Autor : Michelángelo, Hernán 
Angriman, Federico 
Pizarro, Rodolfo 
Bauque, Susana 
Kecskes, Claudia 
Staneloni, inés 
García, David 
Espínola, Fidencia 
Mazer, Gustavo 
Ferrari, Cristina 
Palabras clave : ENSEÑANZA DE LA MEDICINAVENTILACION MECANICAINFECCION HOSPITALARIARESPIRACION ARTIFICIAL
Fecha de publicación : 2019
Editorial : SAGE Publications
Cita : Michelángelo, H., et al. Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients [en línea]. Journal of the Intensive Care Society. 2019. doi:10.1177/1751143719887285 Disponible en: https://repositorio.uca.edu.ar/handle/123456789/9810
Resumen : Abstract: Objective: We evaluated the impact of an experiential learning strategy on both the adherence to the use of bundles and the incidence of ventilator-associated pneumonia in critically ill adult patients. Methods: Longitudinal, quasi-experimental interrupted time-series study in a tertiary teaching hospital in Buenos Aires, Argentina. Successive measurements were made before and after the intervention was implemented between January 2016 and December 2018. Our main exposure was experiential learning, which was based on a combination of play activities, simulation models, knowledge and attitude competencies, role-playing and feedback. The adherence to the bundle for the care of mechanically ventilated critically-ill adult patients and the occurrence of ventilator-associated pneumonia were the main outcomes of interest. We used generalized linear models including time as a linear spline to estimate the effect of the experiential learning strategy both on the adherence to the bundle of care and the occurrence of ventilator-associated pneumonia during long-term follow-up. Results: The overall proportion of adequate bundle use before and after the implementation of the intervention was 60.8% (95% CI: 56.9–64.7) and 85.6% (95% CI: 81.2–90.1), respectively. The incidence rate of ventilator-associated pneumonia before and after the intervention was 6.11 (95% CI: 5.82–6.40) and 3.55 (95% CI: 2.96–4.14) every 1000 days of mechanical ventilation, respectively. The estimated baseline monthly change in the adherence to the mechanical ventilation bundle was 0.4% (95%CI: 0.3–1.2%, p ¼ 0.31) and 1.1% (95% CI: 0.2–2.2%, p < 0.01) before and after the implementation of the intervention, respectively. These results were consistent across our statistical quality control analysis. Conclusions: The implementation of experiential learning strategies improves the adherence to bundles in the care of mechanically ventilated critically ill adult patients. Such strategies also decrease the incidence rate of ventilator-associated pneumonia. Both effects appear to remain constant during long-term follow-up.
URI : https://repositorio.uca.edu.ar/handle/123456789/9810
ISSN : 1751-1437
Disciplina: MEDICINA
DOI: 10.1177/1751143719887285
Derechos: Acceso abierto
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