Liberation from Ventilation: An Intervention Study in Public Adult Intensive Care Units in the Eastern Cape Province of South Africa

Abstract

Implementing evidence-based guidelines is one way of addressing the knowledge gap of critical care nurses regarding the ventilator liberation of critically ill adult patients in South Africa. A quasi-experimental intervention study using a pre-test/post-test design to measure critical care nurses’ knowledge on ventilator liberation of adult patients in intensive care units was conducted. The critical care nurses were purposively sampled into three groups and their knowledge was measured before an educational intervention, and three months after. Data was collected with pre/post-test questionnaires, n1=115 pre-test and n2=90 post-test, respectively. An educational intervention using a PowerPoint presentation, printed copies of the guidelines, posters as reminders, and informal monitoring visits (Intervention Group One) had an insignificant effect (p=0.371; Cohen’s d <0.20) on the improvement of the respondents’ knowledge score (62,93 versus 65,22). Handing out printed copies of guidelines alone (Intervention Group Two) had a small effect (p=0.033; Cohen’s d=0.49 small) but did not improve respondents’ knowledge score (60,34 versus 53,41). The absence of an educational intervention (Control Group) had an insignificant effect (p=0.884; Cohen’s d <0.20) on the improvement of respondents’ knowledge score (59,60 versus 60,33). Across the three groups, intensive care unit experience had a moderate effect (p=0,018; Cohen’s d=0.67 medium) on the way critical care nurses responded to the pre/post-test questionnaires. Respondents lacked knowledge of ventilator liberation practices in the study context, and this can be addressed using combined educational intervention methods. Sequel studies using different educational intervention methods are recommended that take into account the diversity within the study population.