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Effectiveness and implementation outcomes of the multimodal strategy in IPC for pediatric ventilator-associated events at a provincial hospital in Vietnam: a hybrid II implementation design

Published online by Cambridge University Press:  03 September 2025

Dang Thi Thu Huong
Affiliation:
VietNam National Children’s Hospital, Hanoi
Tran Minh Dien
Affiliation:
VietNam National Children’s Hospital, Hanoi
Pham Duy Hien
Affiliation:
VietNam National Children’s Hospital, Hanoi
Nguyen Van Dat
Affiliation:
Bac Ninh Obstetrics and pediatrics Hospital
Le Nho Khue
Affiliation:
Bac Ninh Obstetrics and pediatrics Hospital
Phan Van Tuong
Affiliation:
Hanoi University of Public Health
Anh Thi-Kim Le*
Affiliation:
Hanoi University of Public Health
*
Corresponding author: Anh Thi-Kim Le

Abstract

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Background: Vietnam has the national guidelines for infection control in hospitals and it also recommends the application of WHO’s IPCAF framework to do self-evaluation of infection prevention and control (IPC) activities and plan to improve them in hospitals. Objective: Our study aimed to implement the multimodal strategy for IPC, in which our expected outcome was the practices of doctors and nurses for pediatric ventilator-associated events (Ped-VAE). Design: We used the implementation research approach with the hybrid design of quasi-experimental pre-post comparison without control group. All 16 doctors and 32 nurses at the Department of PICU were observed 3 times that practicing the IPC packages for PedVAE guided by MOH. The implementation strategies used included Plan, Restructure, Train, and Quality Management. Results: Four over six steps practised by doctors and 5/10 steps practised by nurses for PedVAE were well practised after the intervention with significantly higher proportion of right practices (p<0.001). The practices of doctors had insignificant changes between pre-post intervention, including hand hygiene (85.4% and 83.3% of right practice at pre-post intervention, respectively) and daily assessment of weaning from mechanical ventilation (54.2%-68.7%). Most unchanged practices among nurses were steps of ensuring humidification and heating of inhaled gas for in patients with artificial airway.

All practice scores of the whole steps among doctors and nurses had statistically significant increase after intervention. Our implementation strategies were highly assessed by providers (doctors and nurses) and hospital managers in terms of the its acceptibility, feasibility and sustainability. Conclusion: The implementation of multimodal strategy in IPC for pediatric ventilator-associated events is effective and acceptable and feasible for hospitals at city/province level in Vietnam. In addition with improving practices of healthcare staffs, hospitals should regularly assess and upgrade ventilators machines to ensure the effectiveness of IPC.

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Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America