https://doi.org/10.53964/jmnpr.2021005

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Journal ofModern Nursing Practice and Research
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Research Article
Clinical Value of Comprehensive Nursing Intervention in Prevention of Ventilatorassociated Pneumonia
Cuifang Liu1, Yumei Zhou2, Jingjing Zhao2, Nana Geng1*
1

Department of Respiratory Medicine, Shandong Dongying People’s Hospital, Dongying, Shandong Province,
China.
2*

Pediatric Infusion Rooms, Shandong Dongying People’s Hospital, Dongying, Shandong Province, China.

Correspondence to: Nana Geng, Department of Respiratory Medicine, Shandong Dongying People’s
Hospital, Dongying 257000, Shandong Province, China; Email:185484833@qq.com
Received: October 7, 2020 Accepted: January 8, 2021 Published: March 15, 2021

Abstract
Objective: To investigate the clinical value of comprehensive nursing intervention in prevention ofventilator-associated pneumonia.
Methods: From June 2018 to December 2019, a total of 116 patients who received mechanicalventilation were selected as research participants, and they were divided into control group (n=58) andobservation group (n=58) according to the random number table method. In the observation group,
patients were treated with comprehensive nursing, while patients in the control group were treatedwith conventional nursing. The mechanical ventilation time, hospitalization time, VAP incidence,
psychological status, quality of life and nursing satisfaction of patients were compared in the two groups.
Results: The mechanical ventilation and hospitalization time of patients in the observation group wereless than those of patients in the control group, and the difference was statistically significant (P<0.05).
The incidence of VAP was 3.44% in the observation group, which was lower than that in the control
group (13.79%), and the difference was statistically significant (P<0.05). The self-rating anxiety scale(SAS) and self-rating depression scale (SDS) scores of patients in the two groups before intervention
were not of statistically significant difference (P>0.05). After intervention, the SAS and SDS scores
decreased in the two groups, and the scores in the observation group were significantly lower than thosein the control group (P<0.05). The quality of life scores before intervention between the two groups were
not statistically significant (P>0.05). After intervention, the quality of life scores in the observation groupwere higher than those in the control group, and the difference was statistically significant (P<0.05). The
nursing satisfaction rate in the observation group was 94.87%, which was significantly higher than that in
the control group (81.03%) (P<0.05).
Conclusion: Comprehensive nursing intervention can shorten the time of mechanical ventilation andhospitalization, prevent the occurrence of VAP, alleviate the negative emotions of patients, and improvetheir quality of life as well as nursing satisfaction.
Copyright © 2021 The Author(s). This open-access article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, sharing, adaptation, distribution, and reproduction in any medium,provided the original work is properly cited.

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Keywords: comprehensive care, prevention, ventilator-associated pneumonia, clinical value
Citation: Liu C, Zhou Y, Zhao J, Geng N. Clinical Value of Comprehensive Nursing Intervention in Prevention of Ventilatorassociated Pneumonia. J Mod Nurs Pract Res, 2021; 1(1): 5. DOI: 10.53964/jmnpr.2021005.

1 INTRODUCTION
Mechanical ventilation is one of the main rescue
methods for respiratory failure, during which some patients
often have some complications and ventilator-associatedpneumonia (VAP) is one most common case[1,2]. VAP refers
to pneumonia that develops after receiving mechanicalventilation treatment for 48 hours or within 48 hours after
cessation of mechanical ventilation in the absence ofpulmonary infection[3]. Patients with VAP complications
may have difficulty in weaning, which prolongs hospitalstay, seriously affects the quality of life and even threatens
the life safety[4,5]. Therefore, it is vital to find an effective
nursing method to prevent VAP during mechanicalventilation. This study aimed to explore the clinical valueof comprehensive nursing intervention in the prevention ofventilator-associated pneumonia, so as to provide a clinicalreference for the prevention of VAP. The results are reported
as follows.
2 MATERIAL AND METHODS
2.1 General Material
From June 2018 to December 2019, a total of 116 patients
admitted to our hospital for the treatment of mechanicalventilation were selected as study participants. This
study was approved by the hospital’s Ethics Committee.
According to the random number table method, the patientswere divided into control group (n=58) and observationgroup (n=58). The general materials in the two groups werecompared, and the difference was not statistically significant(P>0.05). See Table 1.
2.2 METHODS
2.2.1 Control GroupIn the control group, patients were treated withconventional nursing intervention, including conventional
sputum suction nursing, posture nursing, psychological careand environmental nursing.
2.2.2 Observation GroupIn the observation group, patients were treated withcomprehensive nursing intervention on the basis of thecontrol group. (1) Cognitive and psychological nursing:Patients on mechanical ventilation often had negative
emotions such as anxiety and insecurity due to insufficientknowledge of mechanical ventilation. Nursing staff carriesout detailed disease education for patients, explaining the
purpose of the treatment and possible adverse reactions andmaking adequate psychological preparation for patients[6].
Patients were encouraged to actively face the disease andestablish the confidence of treatment. (2) Environment

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and posture nursing: The indoor environment were
kept ventilated, clean, and quiet with regular bacterial
disinfection, while the temperature and humidity of the ward
were controlled for a comfortable environment. According topatients’ condition, they were helped to be in a comfortable
position with the head, neck and shoulders at the same level.
To ensure the comfort of patients, they could tilt the headback and turn over regularly with help[7]. (3) Strengthening
the nursing of respiratory tract: To ensure the airway patencyof patients, the airway temperature and humidity of thepatients were kept at an appropriate level, and the ventilator
parameters were then adjusted according to their specificconditions. The correct way of spitting was explained tothe patients, and the patients were assisted to turn over theirbodies[8]. (4) Ventilator duct nursing: The ventilator pipes
were replaced and the ventilators were cleaned in time to
avoid cross-infection; The threaded pipe of the ventilator
was changed every week, the condensed water in the
respiratory pipe was cleaned in time, and antibiotics wereused rationally; Intermittent weaning and early withdrawal
of sedatives could reduce the incidence of VAP[9]. And (5)Nutritional support: According to the patients’ situation,
appropriate diet plans were made; Nasal feeding was appliedin patients who could not eat independently.
2.3 Observation Indexes(1) Mechanical ventilation time and hospitalization time;(2) Incidence of VAP. (3) Psychological status: The selfrating anxiety scale (SAS)[10] was used for the evaluation,
among which the severe anxiety score was >69, themoderate anxiety score was 60-69, the mild anxiety score
was 50-59, and the normal score was <50. (2) Self-rating
depression scale (SDS)[11] was used for scoring, among
which severe depression score was >72 points, moderate
depression score was 63-72 points, mild depression score
was 53-62 points, and normal status score was <53 points. (4)Quality of life: The SF-36 scale[12] was used for evaluation,
including psychology, emotion, body and society. The total
score for each item was 100 points. The mean value ofthe four items was used to represent the quality of life. (5)Nursing satisfaction: Nursing satisfaction was evaluatedaccording to the questionnaire designed by the nursing
personnel. There were 8 items in total with five levels
ranging from “very satisfied” to “very dissatisfied”. The
satisfaction rate = (very satisfied + satisfied + average)/
number of cases ×100%.
2.4 Statistical Analysis
SPSS23.0 was used to process the collected data. The
quantitative data that were consistent with normal distribution

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Table 1. Comparison of General Material
Group

n

Observation group
Control group

GenderFemale58

32

26

50.89±8.41

5850.32±8.66

31

27

2

x /t

0.035

0.360

P

0.853

0.720

were expressed by x̅ ±s. The qualitative data were expressed
as n(%). The rank-sum test was performed for ordered
qualitative data, while x2 test was used for the disordereddata. The variance analysis was conducted for repeatedmeasurement data. P<0.05 was considered significantly
different.
3 RESULTS
3.1 Comparison of Mechanical Ventilation and Hospitalization TimeThe time of mechanical ventilation and hospitalizationin the observation group was less than that in the control
group, and the difference was statistically significant(P<0.05). See Table 2.
3.2 Comparison of VAP Incidence
The VAP incidence in the observation group was 3.44%,
which was lower than that in the control group (13.79%),
and the difference was statistically significant (P<0.05). See
Table 3 for details.
3.3 Comparison of Psychological Status
The SAS and SDS scores of the two groups before
intervention were not of significant difference (P>0.05).
After intervention, the SAS and SDS scores decreased inboth groups, while the scores in the observation group werelower than those in the control group and the difference wasstatistically significant (P<0.05). See Table 4 for details.
3.4 Comparison of Quality of Life
The quality of life scores of the two groups before
intervention were not of significant difference (P>0.05).
After intervention, the score in the observation group was
higher than that in the control group, and the difference
was statistically significant (P<0.05). See Table 5 fordetails.
3.5 Comparison of Nursing Satisfaction
The nursing satisfaction in the observation group was
94.87%, which was higher than that in the control group(81.03%), and the difference was statistically significant(P<0.05). See Figure 1.
4 DISCUSSION
VAP is a common nosocomial infection, which is not
only related to patients’ own disease[13], but also related

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to factors of antibiotic use, artificial airway, mistaken
aspiration and mechanical ventilation time[14,15]. Amongthem, mechanical ventilation is an important reason for thedevelopment of VAP in patients. The longer the time of
mechanical ventilation, the higher the incidence of VAP,
which has a negative impact on the prognosis of patients[16].
VAP has a high mortality rate, so it is important to takeappropriate prevention measures.
Comprehensive nursing intervention is a new patientcentered nursing model, which can effectively improve
patients’ nursing services by utilizing various resources[17].
Cross-infection caused by foreign bacteria can beeffectively avoided through environmental nursing in thewards[18]. After the patient’s airway nursing, respiratory tract
mucosal damage can be effectively avoided. Psychologicalnursing intervention can enhance patients’ confidence ingetting cured, improve patients’ nursing and treatmentcompliance, and it is more conducive to the development of
nursing work[19]. After ventilator tube nursing, the bacteria
invasion can be effectively avoided in case of VAP. Aftercomprehensive nursing, VAP can be prevented, mechanicalventilation and hospitalization time can be shortened,
and patients’ quality of life and nursing satisfaction canbe improved[20]. The results of this study showed that themechanical ventilation and hospitalization time in theobservation group were less than those in the control group.
The incidence of VAP in the observation group was 3.44%,
which was lower than that in the control group (13.79%).
The SAS and SDS scores in both groups were reduced after
the intervention, and the scores in the observation groupwere lower than those in the control group. The nursing
satisfaction in the observation group was 94.87%, which
was higher than that in the control group (81.03%). The
results showed that comprehensive nursing can effectively
reduce mechanical ventilation time and hospitalization time,
reduce the incidence of VAP, alleviate patients’ negative
emotions, and improve the quality of life as well as nursing
satisfaction.
5 CONCLUSION
In conclusion, comprehensive nursing intervention canshorten mechanical ventilation time and hospitalization
time, prevent the development of VAP, relieve patients’negative emotions, and enhance their quality of life andnursing satisfaction.

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Table 2. Comparison of Mechanical Ventilation and Hospitalization Time (x ± sd)
Group

n

Mechanical Ventilation Time

Hospitalization Time

Observation group58

15.34±4.15

17.46±5.69

Control group58

23.65±5.71

25.34±6.77

t

8.966

6.876

P

<0.001<0.001

Table 3. Comparison of VAP Incidence (n)
Group

n

With VAP

Without VAP

Observation group

58

2

56

3.44

Control group

58

8

50

13.79

VAP Incidence

x2

3.940

P

0.047

Table 4. Comparison of SAS and SDS Scores (x̅ ± s, score)
Group

n

Observation group
Control group

SAS

SDS

Before Intervention

After Intervention

Before Intervention

After Intervention

58

61.52±6.32

44.15±4.81*

55.41±5.38

46.21±4.26*

58

61.37±6.15

57.41±5.17*

55.93±5.13

50.14±4.72*

t

0.130

14.301

0.533

4.707

P

0.897

<0.001

0.595<0.001

Notes: *stands for comparison with the data before intervention, P<0.05.
Table 5. Comparison of Quality of Life (x̅ ± sd, score)
Group

n

Before Intervention

After Intervention

Observation group58

65.78±12.14

87.64±15.98*

Control group58

66.88±12.32

73.65±15.72*

t

0.484

4.753

P

0.629

<0.001

Notes: *stands for comparison with the data before intervention, P<0.05.

Figure 1. Comparison of nursing satisfaction between the two groups.

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Acknowledgements
Not applicable.

[9]

Conflicts of Interest
The authors declared no conflict of interest.

[10]

Author Contribution
Geng N designed this study and wrote the article; Liu C
and Zhou Y collected the data and performed the statisticalanalysis; Zhao J revised the papers for important intellectual
content; all authors approved the final version.
Abbreviation List
SAS, Self-rating anxiety scale
SDS, Self-rating depression scale
VAP, Ventilator-associated pneumonia[12]

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