Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients

Autores
Michelángelo, Hernán; Angriman, Federico; Pizarro, Rodolfo; Bauque, Susana; Kecskes, Claudia; Staneloni, inés; García, David; Espínola, Fidencia; Mazer, Gustavo; Ferrari, Cristina
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Fil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; Argentina
Fil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Angriman, Federico. University of Toronto. Interdepartmental Division of Critical Care Medicine. Department of Critical Care, Sunnybrook Health Sciences Center; Canadá
Fil: Pizarro, Rodolfo. Hospital Italiano de Buenos Aires. Departamento de Cardiología; Argentina
Fil: Bauque, Susana. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; Argentina
Fil: Kecskes, Claudia. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; Argentina
Fil: Staneloni, inés. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; Argentina
Fil: García, David. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Espínola, Fidencia. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Mazer, Gustavo. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Ferrari, Cristina. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas; Argentina
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.
Fuente
Journal of the Intensive Care Society. 2019
Materia
ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/4.0/
Repositorio
Repositorio Institucional (UCA)
Institución
Pontificia Universidad Católica Argentina
OAI Identificador
oai:ucacris:123456789/9810

id RIUCA_96efae17b9ec6a9e3e904efb99b09cb2
oai_identifier_str oai:ucacris:123456789/9810
network_acronym_str RIUCA
repository_id_str 2585
network_name_str Repositorio Institucional (UCA)
spelling Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patientsMichelángelo, HernánAngriman, FedericoPizarro, RodolfoBauque, SusanaKecskes, ClaudiaStaneloni, inésGarcía, DavidEspínola, FidenciaMazer, GustavoFerrari, CristinaENSEÑANZA DE LA MEDICINAVENTILACION MECANICAINFECCION HOSPITALARIARESPIRACION ARTIFICIALFil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; ArgentinaFil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Calidad; ArgentinaFil: Angriman, Federico. University of Toronto. Interdepartmental Division of Critical Care Medicine. Department of Critical Care, Sunnybrook Health Sciences Center; CanadáFil: Pizarro, Rodolfo. Hospital Italiano de Buenos Aires. Departamento de Cardiología; ArgentinaFil: Bauque, Susana. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; ArgentinaFil: Kecskes, Claudia. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; ArgentinaFil: Staneloni, inés. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; ArgentinaFil: García, David. Hospital Italiano de Buenos Aires. Departamento de Calidad; ArgentinaFil: Espínola, Fidencia. Hospital Italiano de Buenos Aires. Departamento de Calidad; ArgentinaFil: Mazer, Gustavo. Hospital Italiano de Buenos Aires. Departamento de Calidad; ArgentinaFil: Ferrari, Cristina. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas; ArgentinaAbstract: 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.SAGE Publications2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfhttps://repositorio.uca.edu.ar/handle/123456789/98101751-143710.1177/1751143719887285Michelángelo, 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/123456789/9810Journal of the Intensive Care Society. 2019reponame:Repositorio Institucional (UCA)instname:Pontificia Universidad Católica Argentinaenginfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/4.0/2025-07-03T10:57:16Zoai:ucacris:123456789/9810instacron:UCAInstitucionalhttps://repositorio.uca.edu.ar/Universidad privadaNo correspondehttps://repositorio.uca.edu.ar/oaiclaudia_fernandez@uca.edu.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:25852025-07-03 10:57:16.426Repositorio Institucional (UCA) - Pontificia Universidad Católica Argentinafalse
dc.title.none.fl_str_mv Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
spellingShingle Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
Michelángelo, Hernán
ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
title_short Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_full Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_fullStr Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_full_unstemmed Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
title_sort Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
dc.creator.none.fl_str_mv Michelángelo, Hernán
Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
author Michelángelo, Hernán
author_facet Michelángelo, Hernán
Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
author_role author
author2 Angriman, Federico
Pizarro, Rodolfo
Bauque, Susana
Kecskes, Claudia
Staneloni, inés
García, David
Espínola, Fidencia
Mazer, Gustavo
Ferrari, Cristina
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
topic ENSEÑANZA DE LA MEDICINA
VENTILACION MECANICA
INFECCION HOSPITALARIA
RESPIRACION ARTIFICIAL
dc.description.none.fl_txt_mv Fil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; Argentina
Fil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Angriman, Federico. University of Toronto. Interdepartmental Division of Critical Care Medicine. Department of Critical Care, Sunnybrook Health Sciences Center; Canadá
Fil: Pizarro, Rodolfo. Hospital Italiano de Buenos Aires. Departamento de Cardiología; Argentina
Fil: Bauque, Susana. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; Argentina
Fil: Kecskes, Claudia. Hospital Italiano de Buenos Aires. Departamento de Cuidados Intensivos; Argentina
Fil: Staneloni, inés. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; Argentina
Fil: García, David. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Espínola, Fidencia. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Mazer, Gustavo. Hospital Italiano de Buenos Aires. Departamento de Calidad; Argentina
Fil: Ferrari, Cristina. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas; Argentina
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.
description Fil: Michelángelo, Hernán. Hospital Italiano de Buenos Aires. Departamento de Medicina Interna; Argentina
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://repositorio.uca.edu.ar/handle/123456789/9810
1751-1437
10.1177/1751143719887285
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
url https://repositorio.uca.edu.ar/handle/123456789/9810
identifier_str_mv 1751-1437
10.1177/1751143719887285
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
dc.language.none.fl_str_mv eng
language eng
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/4.0/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/4.0/
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv SAGE Publications
publisher.none.fl_str_mv SAGE Publications
dc.source.none.fl_str_mv Journal of the Intensive Care Society. 2019
reponame:Repositorio Institucional (UCA)
instname:Pontificia Universidad Católica Argentina
reponame_str Repositorio Institucional (UCA)
collection Repositorio Institucional (UCA)
instname_str Pontificia Universidad Católica Argentina
repository.name.fl_str_mv Repositorio Institucional (UCA) - Pontificia Universidad Católica Argentina
repository.mail.fl_str_mv claudia_fernandez@uca.edu.ar
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score 13.070432