F: Effectiveness of 30°-45° Head-Up Positioning, Closed Suctioning, and Oral Hygiene as VAP Prevention Bundle in Mechanically Ventilated Patients in ICU at dr. Soebandi Regional Hospital, Jember

Abstract

Ventilator-associated pneumonia (VAP) is a nosocomial infection of the lung tissue that most often occurs in patients undergoing mechanical ventilation in intensive care units, with a high morbidity and mortality rate of 1% per day. The incidence of VAP can be prevented through a specific procedure, known as the VAP Bundle. The method in the VAP Bundle includes head-up positioning at 30°-45°, mucus suction, and oral hygiene using 0.2% chlorhexidine aseptic solution. This study aims to evaluate the effectiveness of the VAP Bundle, consisting of a 30°-45° head-up position, close suction, and oral hygiene with 0.2% chlorhexidine aseptic, in preventing the risk of VAP at dr. Soebandi Jember Regional Hospital. This study employed a descriptive case study design, focusing on one patient who met the inclusion and exclusion criteria. The instrument used was the Modified Clinical Pulmonary Infection Score (MCPIS), which was measured daily for a six-day intervention period. The results showed that during the six-day intervention, the patient's MCPIS score remained <5, meaning the patient did not experience VAP. Furthermore, the patient's general clinical condition showed no infiltration, the secretions were not purulent, and the temperature decreased at the end of the intervention. These findings indicate that the independent implementation of the VAP Bundle by nurses is effective in reducing the risk of VAP in patients with mechanical ventilation. Thus, the VAP Bundle intervention, which includes a 30°-45° head-up position, close suction, and oral hygiene with 0.2% chlorhexidine, has been proven effective as a VAP prevention effort in critically ill patients on ventilators in the ICU.

Keywords: Ventilator-Associated Pneumonia; Head Up; Suction; Oral Hygiene; Chlorhexidine