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Background: Ventilator‐associated pneumonia is common and associated with high mortality. Nurses play a fundamental role in preventing ventilator‐associated pneumonia. Evidence‐based guidelines and training interventions about preventing ventilator‐associated pneumonia do not ensure compliance with recommendations. Aims and objective: To evaluate the impact of nursing workload on compliance with non‐pharmacological measures to prevent ventilator‐associated pneumonia. Design A prospective observational study in two medical‐surgical adult ICUs in Spain. Methods: We measured nurses' knowledge about preventing ventilator‐associated pneumonia through a questionnaire and workload, categorized with the Nine Equivalents of Nursing Manpower Use Score. We directly observed nurses to measure compliance with non‐pharmacological measures to prevent ventilator‐associated pneumonia. Results: A total of 97 nurses were studied; 76 (79%) were observed. There were 327 observations (mean 4·30 observations per nurse). The questionnaire showed good baseline knowledge of preventive measures [mean score (92% ± 16%)]. Nurses complied with the preventive measures in 66% ± 15% of observations; compliance ranged from 11·9% for pre‐aspiration hand washing to 99·7% for using sterile aspiration probes. Mean Nine Equivalents of Nursing Manpower Use Score for each nurse observed was 50 ± 13, without differences between centres (49 ± 14 versus 51 ± 11, p = 0·4). Overall compliance was lower in the light workload group (p = 0·02), but no significant differences in compliance between workload groups were found when each measure was analysed separately. Compliance was higher in nurses aged 31–40 years than in those aged >51 years, although workload was similar in both groups. Conclusions: Compliance with non‐pharmacological measures to prevent ventilator‐associated pneumonia varies widely; non‐compliance is not because of increased workload. Relevance to clinical practice: Most critical care nurses have good baseline knowledge of non‐pharmacological measures to prevent ventilator‐associated pneumonia. Failure to comply with these measures is probably more related with behavioural, structural and organizational aspects than with nursing workload. Interventions to improve compliance might be more effective if they focus on factors such as work climate and professionals' attitudes. [ABSTRACT FROM AUTHOR]

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Background: Delirium is a poor recognized and common disease where early identification is of great importance due to its accompanying morbidities. The main objective of this study was to prove implementation of an educational program to health care professionals as an effective strategy to reduce delirium incidence and to help in early detection. Material and methods: A preventive program was developed based on non-pharmacological measures and with support from patient relatives consisting in educational sessions, didactic material and questionnaires as well as specific strategies for all patients above 65 years old admitted to the hospital and within inclusion criteria. results: 189 patients were included in the study where just one developed delirium despite the non-pharmacological preventive measures. Two evaluations were made to physician and nursing personal before and after implementation of the program where an improvement in ability to identify disease was seen (initial 22% versus 94%; p=0.000). After a year of beginning implementation of the program the reduction in the incidence of delirium in the study group was statistically significant respect to previous incidence reported in the hospital (10% versus 0.5%; p= 0.0001) Conclusions: Implementation of a delirium preventive program was feasible. As the satisfactory results in our study it is recommended to be considered for implementation in all hospitals in order to reduce incidence of delirium and its morbidities. [ABSTRACT FROM AUTHOR]

Abstract: Background: The objective of the study was to investigate the effectiveness of non-pharmacological interventions in preventing cases of influenza requiring hospitalization. Methods: We performed a multicenter case-control study in 36 hospitals, in 2010 in Spain. Hospitalized influenza cases confirmed by reverse-transcription polymerase chain reaction and three matched controls (two hospital and one community control) per case were selected. The use of non-pharmacological measures seven days before the onset of symptoms (frequency of hand washing, use of alcohol-based hand sanitizers and handwashing after touching contaminated surfaces) was collected. Results: We studied 813 cases hospitalized for influenza and 2274 controls. The frequency of hand washing 5-10 times (adjusted odds ratio [aOR]=0.65) and >10 times (aOR=0.59) and handwashing after contact with contaminated surfaces (aOR=0.65) were protective factors and were dose-responsive (p<0.001). Alcohol-based hand sanitizers were associated with marginal benefits (aOR=0.82). Conclusions: Frequent handwashing should be recommended to prevent influenza cases requiring hospitalization. [Copyright &y& Elsevier]