[Using TRM to Enhance the Accuracy of Ventilator-Associated Pneumonia Preventive Measures Implemented by Neonatal Intensive Care Unit Medical Staffs].

BACKGROUND & PROBLEMS: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP. PURPOSE: To improve the accuracy of implementation of preventive measures for VAP among medical staffs and reduce the density of VAP infections in the NICU. RESOLUTIONS: Conduct a literature search and adopt medical team resources management methods; establish effective team communication; establish monitoring mechanisms and incentives; establish mandatory in-service specialization education contents and a VAP preventive care guide exclusively for newborns as a reference for medical staffs during care execution; install additional equipment and aids and set reminders to ensure the implementation of VAP preventive measures. RESULTS: The accuracy rate of preventive measure execution by medical staffs improved from 70.1% to 97.9% and the VAP infection density in the NICU decreased from 4.7‰ to 0.52‰. CONCLUSIONS: Team integration effectively improved the accuracy of implementation of VAP-prevention measures, reduced the density of VAP infections, enhanced quality of care, and ensured that newborns received care that was more in line with specialization needs.

[Improving the provision of nesting and positioning for premature infants by nurses in neonatal intensive care units].

BACKGROUND & PROBLEMS: Nesting and positioning is a common nursing skill used in the developmental care of premature infants. This skill maintains premature infants in a comfortable position, facilitates the monitoring of stable vital signs, and enables spontaneous motor activity for normal neuromuscular and skeletal joint function. PURPOSE: This project was designed to improve nursing staff cognition and skills regarding nesting and positioning for premature infants in the NICU. RESOLUTIONS: Strategies used in this project were: develop an infant position assessment tool; record a demonstration video about nesting and positioning skills to provide learning efficacy among the nursing staff; and modify an education program for new nurses. RESULTS: After implementation, nurse cognition regarding premature infant nesting and positioning increased from 58.3% to 92.3%. The rate of correct technique use similarly rose from 63.3% to 91.4%. CONCLUSIONS: This is a valid intervention for improving the correctness of nesting and positioning in nursing care. This project standardized education in terms of nesting and positioning practice goals and enhanced quality care for premature infants.