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
- Institución
- Pontificia Universidad Católica Argentina
- OAI Identificador
- oai:ucacris:123456789/9810
Ver los metadatos del registro completo
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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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1836638350796128256 |
score |
13.070432 |