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 serious complications that often occur in patients with mechanical ventilation in Intensive Treatment Unit. 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, normal saline 0.9% installation. This study aims to analyze effect VAP bundle application and normal saline 0.9% installation to VAE incidence in ICU RSUD Mardi Waluyo Blitar. Research method uses the quasi-experimental design with  pretest-posttest with control group design. Research sample consists patients who use mechanical ventilator according to inclusion criteria, divided into control and intervention groups. Bundle VAP implemetation to VAC insidence (P= 0,317) and IVAC insidence (p = 0,083), normal salin instalation VAC (p = 0,083) and IVAC insidence (p = 0,001), result  ordinal regression. p-value 0,002 for Bundle VAP implemetation and p = 0,121 for normal salin installation. Regression analysis shows that Bundle VAP is protective factor for VAE incidence, while saline installation has additional effect strengthens prevention. Conclusion this research confirms importance implementation VAP Bundle consistently as main strategy  preventing VAE in ICU. Normal saline installation can considered additional and easily applied additional intervention. Clinical implications study are need strengthen hospital policy implementation VAP bundle and socialization use normal saline as part patient care protocol with mechanical ventilation.