Evidence-Based Nursing to Reduce Adverse Events Regarding Ventilator Associated Pneumonia, Pressure Injuries and Central Line Bloodstream Infection in Intensive Care Unit in Bangladesh

NCT ID: NCT07299799

Last Updated: 2025-12-23

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 272 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-20
• Study Completion Date: 2026-05-30

Brief Summary

Quality of care is crucial for preventing adverse events such as infection in the intensive care units (ICUs). The most common ICU-acquired infections include pneumonia such as Ventilator Associated Pneumonia (VAP), Pressure Ulcer (PU), Medical Device Related Pressure Ulcer (MDRPU), and Central Line-Associated Bloodstream Infection (CLABSI). VAP, PU, and MDRPU are significant indicators of the quality of care, while CLABSI is a critical marker of healthcare quality in ICUs, as it is largely preventable through strict adherence to infection control protocols.

VAP is a lung infection that occurs in patients receiving mechanical ventilation for more than 48 hours. A PU is defined as localized damage to the skin or underlying tissue caused solely by pressure, while MDRPUs may also result from friction or pressure from medical devices or other objects. CLABSI is a severe infection caused by improperly inserted or maintained central venous catheters, which underscores the need for stringent catheter management protocols.

Detailed Description

General Objective:

The objective of this study is to evaluate whether implementing EBP and changing nurses' competency (skill, knowledge, practice, and attitude) can reduce ICU adverse events such as VAP, PU, MDRPU, and CLABSI, and improve patient outcomes.

Specific Objectives:

1. To identify insights on perceptions, barriers, and facilitators related to EBP implementation in the ICU setting.

2. To evaluate the effect of EBP training on nurses' competency (skill, knowledge, practice, and attitude) regarding EBP for CLABSI, PU, and MDRPU in an ICU setting.

3. To evaluate the effects of EBP on ICU patient incidence rates of VAP, CLABSI, PU, and MDRPU.

Hypothesis:

H1- Hypothesize that training on EBP and its implementation in ICU settings will improve nurses' competency (Skill, knowledge, practice and attitude).

H2- Hypothesize that implementation of EBP by trained ICU nurses will reduce adverse events-such as VAP, pressure ulcers, medical device-related PU, and CLABSIs-and improve overall patient outcomes.

These research consist of two studies:

1. Evaluating the effect of EBP training on ICU nurses' competency (skill, knowledge, practice, and attitude) regarding EBP for CLABSI, PU, and MDRPU in an ICU setting.

A pre- and post-quasi-experimental study will be conducted over a 16-month period, with a total data collection period of 6 months, to evaluate nurses' competency. The study consists of a recruitment period (1 month), nurses' baseline data collection (1 month), nurses' EBP training with midline data collection (2 months), and nurses' endline data collection during EBP implementation (2 months).

Study nurses will receive EBP training and appropriate equipment for patient management. EBP education and training will be provided with necessary equipment, such as a closed suction catheter, an endotracheal tube, a suction device, and a mouth care brush. In this study, global standard equipment will be used to ensure patient safety.

2. Evaluating the effect of EBP implementation on ICU patient incidence rates of VAP, CLABSI, PU, and MDRPU.

A pre- and post-quasi-experimental design with a non-equivalent control group (Study 1, Phase 1 data used as historical data) will be applied by comparing the rate of adverse events such as VAP, CLABSI, PU, and MDRPU before and after the EBP intervention (2-month baseline data and 2-month intervention data will be collected).

Conditions

Ventilator Acquired Pneumonia; Central Line Associated Blood Stream Infections (CLABSI); Pressure Ulcer (PU); Medical Device Related Pressure Ulcer (MDRPU)

Keywords

evidence based practice; Nurses competency; Ventilator Associated Pneumonia; Pressure Ulcer; Central Line Bloodstream Infection; Medical Device Related Pressure Ulcer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Experimental: Trial 1: All Nurses in GICU; Trial 2: All patients admitted in the general GICU

Nurses: All nurses who work at GICU of DMCH Patients: all patients who will admit at the assigned GICU during the study period of DMCH

Group Type: EXPERIMENTAL

Education with EBP

Intervention Type: BEHAVIORAL

Trial 1: Nurse's EBP training ( VAP, PU, MDRPU, CLABSI management), online lecture, 2 hours lecture and 3 hours skill training for nurses training.

Trail 1 we use advanced equipment necessary for EBP implementation for VAP, PU, MDRPU and CLABSI management, and EBP-trained nurses implementation for all this management.

This is a pre- and post- quasi-experimental study.

Intervention Type: BEHAVIORAL

We will use advanced equipment and implement EBP (VAP, PU, MDRPU and CLABSI management) for patients by trained nurses and check the outcome of the patients. We will compare pre and post findings for this study.

Interventions

Education with EBP

Trial 1: Nurse's EBP training ( VAP, PU, MDRPU, CLABSI management), online lecture, 2 hours lecture and 3 hours skill training for nurses training.

Trail 1 we use advanced equipment necessary for EBP implementation for VAP, PU, MDRPU and CLABSI management, and EBP-trained nurses implementation for all this management.

Intervention Type: BEHAVIORAL

This is a pre- and post- quasi-experimental study.

We will use advanced equipment and implement EBP (VAP, PU, MDRPU and CLABSI management) for patients by trained nurses and check the outcome of the patients. We will compare pre and post findings for this study.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

Nurse

• who is a registered nurse in Bangladesh.
• who agrees to participate in this study and the EBP training.
• who will stay at the ICU for 6 months. Patient
• Irrespective of age and sex, participants must be at least 18 years old
• Legal guardian of a patient consent to participation in the study

Exclusion Criteria

Nurse

• Who will not directly involve patient care in ICU. Patient

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Hiroshima University

OTHER

Sponsor Role: lead

Responsible Party

Nahida Akhter

Principal Investigator, Ph.D Fellow, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Dhaka Medical College Hospital

Dhaka, Dhaka Division, Bangladesh

Hiroshima University

Hiroshima, Hiroshima City, Japan

Countries

Bangladesh; Japan

Central Contacts

Nahida Akhter, Ph. D Fellow

Role: CONTACT

Phone: +8801925478065

Email: nahida1789@gmail.com

Moriyama Michiko, Ph.D

Role: CONTACT

Phone: +81-82-257-5367

Email: morimich@hiroshima-u.ac.jp

Facility Contacts

Nahida Akhter, PhD Fellow

Role: primary

Moriyama Michiko, PhD

Role: primary

Other Identifiers

BMRC/NREC/2025-2027/313

Identifier Type: -

Identifier Source: org_study_id

65313072025

Identifier Type: REGISTRY

Identifier Source: secondary_id

24K02733

Identifier Type: REGISTRY

Identifier Source: secondary_id