Effective Implementation of Ventilator Care Bundles in Improves Outcomes: A Multicenter Randomized Controlled Clinical Trial.

OBJECTIVES To evaluate the effect of 17-ventilator care bundles and different training strategies for critical care nurses on clinical outcomes. DESIGN A randomized controlled triple-blinded clinical trial. SETTING The multicenter study was conducted in four academic teaching hospitals in Tehran, Iran, from October 2011 to June 2015. PATIENTS A total of 1,600 adult patients (age ≥ 18 yr) who were admitted to mixed medical-surgical ICUs (> 72 hr) and received invasive ventilation (> 48 hr) were included in this study. In addition, 160 critical care nurses were recruited through letters and telephone and face-to-face invitations. INTERVENTIONS Seventeen-ventilator care bundles applied by four different groups of nurses. MEASUREMENTS AND MAIN RESULTS Clinical outcomes were compared between four groups of study which include three intervention groups (who received 17-ventilator care bundles by trained nurses) and one control group (who received routine care). According to the results, ICU length of stay, non-ICU length of stay, ventilator-associated pneumonia occurrence date, ventilator-associated pneumonia, and mortality rates were significantly higher in control group compared with other groups. CONCLUSIONS Critical care nurses training program to accurately implement 17-ventilator care bundles improves outcomes.