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

NCT07299799 | Not Yet Recruiting DMC

• 3 other identifiers: BMRC/NREC/2025-2027/3136531307202524K02733
• Study Type: interventional
• Target: 272
• Locations: 2 countries
• Sites: 2

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.

Conditions

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

Keywords

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

Outcome Measures

Primary Outcomes (2)

• The nurse's skill related to the PU, MDRPU and CLABSI total score measured by the researcher-developed checklist

  1\. The nurse's skill and knowledge related to the PU, MDRPU and CLABSI checklist. Researcher developed checklist, 50 items with 0: not correct/did not do, 1: partially correct, 2: correct. Score range 0-114.

  6 month data collection and total time frame of this study 16 months

• Incidence rates of PU, MDRPU and CLABSI.

  The incidence rate of PU was calculated as the number of newly developed pressure ulcers after hospitalization per 1000 person-days at risk. The incidence rate of MDRPU was calculated as the number of newly developed MDRPU cases per 1000 patients assessed. The incidence rate of CLABSI was calculated as the number of CLABSI cases per 1000 central line-days. Data will be collected: Patients' demographic data (age, sex, occupation etc.) Medical past and current history (diagnosis, treatment, medication, hospitalization). Reasons and date to be admitted to ICU. Treatment in ICU. Daily laboratory data taken in ICU. Daily biological data including vital signs. Results of patients' stay during ICU. Diagnosis of PU, MDRPU and CLABSI included of this list.

  2 month for data collection and total time frame 16 months.

Secondary Outcomes (7)

• Nurses' knowledge, Attitude and Practice (KAP) related to the PU, MDRPU and CLABSI prevention measured by the researcher-developed scale based on Knowledge of EBP guidelines for the PU, MDRPU and CLABSI prevention scale

  Total data collection time 6 months within 16 months

• Rate (number of patients) of each stage of PU and MDRPU

  Total 2 months

• Micro-organism link to CLABSI

  2 months

• Incidence and rate of VAP

  2 months

• Mortality and morbidity rate of adverse events

  2 months

Other Outcomes (3)

• APACHE II score

  2 months

• SOFA score

  2 months

• GCS score

  2 months

Study Arms (1)

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

EXPERIMENTAL

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

Behavioral: Education with EBP; Behavioral: This is a pre- and post- quasi-experimental study.

Interventions

Education with EBP 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.

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

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

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

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

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

Sponsors & Collaborators

• Hiroshima University: lead

Study Sites (2)

Dhaka Medical College Hospital

Dhaka, Dhaka Division, Bangladesh

Location

Hiroshima University

Hiroshima, Hiroshima City, 7348551, Japan

Location

MeSH Terms

Conditions

Pneumonia, Ventilator-Associated; Pressure Ulcer

Interventions

Educational Status

Condition Hierarchy (Ancestors)

Healthcare-Associated Pneumonia; Cross Infection; Infections; Pneumonia; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Skin Ulcer; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics

Central Study Contacts

Nahida Akhter, Ph. D Fellow

CONTACT

+8801925478065; nahida1789@gmail.com

Moriyama Michiko, Ph.D

CONTACT

+81-82-257-5367; morimich@hiroshima-u.ac.jp

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Ph.D Fellow, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.

Model Details: Trial 1: A pre- and post- quasi-experimental study to evaluate the nurses competency (Skill, knowledge, practice and attitude). Trial 2: A pre- and post- quasi-experimental study to evaluate the outcomes of the patients in the ICU using study 1 Phase 1 data as historical data.

Study Record Dates

• First Submitted: November 23, 2025
• First Posted: December 23, 2025
• Study Start: February 15, 2026
• Primary Completion (Estimated): May 30, 2026
• Study Completion (Estimated): May 30, 2026
• Last Updated: February 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

JP (1); BA (1)