Effect of Coaching on Knowledge and Practice among Nurses in the use of Ventilator Care Bundle in the Prevention of Ventilator-Associated Pneumonia in the Critical Care Units of the Uganda Heart Institute a Specialized Hospital in Kampala

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is one of the most commonly encountered hospital-acquired infections in the intensive care units worldwide. In Uganda, VAP is one of three infections that account for all nosocomial infections. The ventilator care bundle (VCB) is widely proposed and implemented in most hospitals, especially in developed countries, as an effective preventive measure against VAP. However, lack of knowledge and practice by nurses has hampered the implementation of the VCB guidelines for VAP prevention in Uganda, despite its availability in the ICUs. Studies elsewhere suggest that clinical coaching improves clinical knowledge, practices and decisions of nurses. There are no previous studies in Uganda that have investigated this linkage. Understanding this association can improve the delivery of positive patient care and outcomes. Objective: This study aimed to investigate the effect of coaching on clinical knowledge and practice among nurses on the use of ventilator care bundle in the prevention of ventilator-associated pneumonia in CCUs of the Uganda Heart Institute, a specialized hospital in Kampala. Methods: The study utilized the quantitative one-group, pre-test and post-test quasi-experimental design. Data were gathered using structured survey questionnaires from 36 nurses working in the critical care units of the Uganda Heart Institute. The survey participants were selected using the Krejcie and Morgan (1970) formula for determining sample size. Data were entered and prepared for analysis in IBM SPSSv25. Results: Of the 36 nursing participants, 69% were female and 31% were male. The paired t-test showed that there was a statistically significant difference between knowledge of nurses before coaching (m = 16.1, sd = 3.2) and knowledge of nurses after coaching (m = 30.2, sd = 2.5), p < .001. The Wilcoxon signed ranks test indicated that there was a statistically significant difference between practice of nurses before coaching (m = 3.62, sd = .29) and practice of nurses after coaching (m = 4.14, sd = .23), p < .001. The change in the nurses’ mean knowledge levels was greater than the change in the practice levels. Conclusion: Coaching was a useful intervention for improving the knowledge and practice levels of nurses in using VCB to prevent VAP. Recommendations: CCUs in Uganda should conduct regular coaching or related education initiatives for nurses in order to maintain an optimum standard of knowledge and practices of using VCB to prevent VAP.