Effect Application Bundle VAP and Installation Normal 0.9% on the Ventilator Associated Events Incidence in ICU RSUD Mardi Waluyo Hospital Blitar City

Abstract

Ventilator-Associated Events (VAE) is one of the serious complications that often occur in patients with mechanical ventilation in the Intensive Treatment Unit (ICU). VAE includes ventilator-associated condition (VAC), infection-related ventilator-associated complications (IVAC), and Possible Ventilator-Associated Pneumonia (PVAP), which can increase morbidity, mortality, length of treatment, and maintenance costs. VAE prevention efforts are focused on applying the ventilator maintenance bundles and additional interventions, one of which is the use of normal saline installation 0.9%. This study aims to analyze the effect of the application of the VAP bundle and normal installation of 0.9% copy to the VAE incidence in the ICU Room of Mardi Waluyo Hospital, Blitar City. The research method uses the quasi-experimental design with a pretest-posttest with control group design. The research sample consists of patients who use mechanical ventilator according to inclusion criteria, divided into control and intervention groups. Data analysis is carried out univariate, bivariate using the Wilcoxon test, as well as multivariates through logistics/nominal regression regression. The results showed a significant decrease in the incidence of VAC and IVAC after the application of the VAP bundle compared to before the intervention. The application of bundles combined with normal installation of 0.9% copy in the intervention group has proven to be more effective in reducing the incidence of VAE than the control group. Regression analysis shows that the Bundle VAP is a protective factor for the incidence of VAE, while saline installation has an additional effect that strengthens prevention. The conclusion of this research confirms the importance of the implementation of the VAP Bundle consistently as the main strategy of preventing Vae in the ICU. In addition, the normal installation of 0.9% copy can be considered as an additional and easily applied additional intervention. Clinical implications of this study are the need to strengthen hospital policy in the implementation of the VAP bundle and the socialization of the use of normal saline as part of the patient care protocol with mechanical ventilation.