Baker, 2000).The Measurement of Project Effectiveness, an

¶ … Baker, 2000).The measurement of project effectiveness, an element of project impact evaluation, is crucial for the success of every proposed project. In this section, we present the method/mechanism for evaluating the effectiveness of the proposed solution. The process starts with the identification of the project users (Ventilation associated pneumonia patients), gathering data to be used in determining if the user received output, identification of process of transmission and ends up with the change process.

This is indicated in the flowchart model (see figure 1.) which provides for an elaborate systematic way of examining the process within the proposed project and the outcome of the proposed project.

The evaluation of the outcomes is the major purpose of the framework even though the outcomes can never be seen in total isolation of the proposed project "mechanics" (including transmission, project reception as well as use).At certain points in the project evaluation framework, it is absolutely necessary to king of "go back" and effectively examine the absolute effectiveness of the mechanical stages in the project evaluation project and the resultant expected change. Figure 1.

The variables to be assessed when evaluating project outcomes The variables to be assessed when evaluating project outcomes are numerous. They include the following. 1. Ventilator days (VD) 2. VAP, No. (%) of patients 3. VAP rate (per 1000 VD) 4. MICU patient days (PD, all patients 5. Utilization ratio (VD/PD) 6. Duration of ventilation, mean, days 7. Days in MICU (ventilator patients), mean 8. Time to VAP, mean, days 9. Mortality (ventilator patients), No.

(%) Ventilator days (VD) A ventilator day is the number of days in which a given patient is placed on a ventilator as part of his or her treatment regiment. The risk and costs associated with VAP increases with an increase in the number of ventilator days (VD) (Hugonnet et al.,2004). VAP, No. (%) of patients The variable VAP, No. (%) of patients indicates the number of patients suffering from VAP out of the general patient population.

VAP rate (per 1000 VD) The variable VAP rate (per 1000 VD) indicates the rate of VAP per a thousand ventilator days. MICU patient days (PD, all patients) The variable MICU patient days (PD, all patients) denotes the total number of days that all patients in Medical Intensive Care Unit (MICU) take before death or discharge. Utilization ratio (VD/PD) The variable Utilization ratio (VD/PD) denotes the total number of ventilation days which were beneficial to the patient before they got discharged or contracted VAP.

Duration of ventilation, mean, days This variable denotes the average duration in terms of days that a patient was under ventilation (using a ventilator). Days in MICU (ventilator patients), mean This variable denotes the total number of days that ventilator patients in Medical Intensive Care Unit (MICU) take before death or discharge. Time to VAP, mean, days This variable denotes the average number of days before a patient contracted VAP. Mortality (ventilator patients), No. (%) This variable denotes the rate of death of ventilator patients as a result of VAP.

The developed tools necessary for educating project participants Several tools will be used in educating the project participants. These tools are necessary to enable the project participants come to an absolute understanding of the project mechanics. Some of these tools are used in data collection such as questionnaires while others are purely for research and educational purposes.

The ones for research and educational purposes include computer systems and resources like the internet, blackboard that are used in seminars, peer reviewed medical and clinical journals on VAP, projector, photo slides, PowerPoint presentations, medical abstracts among many others. Tools to educate project participants In this particular project, the tools to be used in providing VAP-bundle education will be tailored to be used with the clinicians and the whole MICU staff who will be involved in the management of patients placed under mechanical ventilation.

This will be done with the view of having it being one of the efforts aimed at reducing the incidences of VAP. This will be done in light of the fact and appreciation of the power of education. This assertion is supported by the work of Apisarnthanarak et al. (2007) which indicated that educational programs are indeed effective in the reduction of ventilator-associated pneumonia.

The clinical nurse leaders as well as a selected number of staff nurses worked together to develop a PowerPoint presentation to be used in educating the project participants on the implementation of VAR bundle techniques/practices for use in VAP prevention. The distribution of the handouts to be used in describing the newly formed initiative with the appropriate steps necessary to mitigate cases of VAP There is a need for a pre and post evaluation of the described educational program in order to indicate the levels of learning.

Assessment tools necessary to for the evaluation of project outcomes The assessment tools will include an evaluation test. The test will be used for evaluating the effectiveness of the education activity before exposing the participant to the core project details. The other tool used in the ventilator bundle audit tool.

This was developed by the implementation team to help in keeping of the electronic medical records of each and every ventilator record.The tool iis important since it can record, accurately, all the patient ventilator variables like sedation vacation, HOB elevation > 30 degrees, DVT prophylaxis implementation, sedation vacation in last 24-hour, oral care every 4 hours etc. The level of compliance with the VAP bundle can be measured by an assessment of the time of completion.

The distribution of the result The spread of the outcome of the new prevention practices to a nursing community and to a number of key stakeholders is a significant way in the implementation of the project. So often, clinicians, healthcare institutions and other departments of nursing normally fail to learn the success of the project change because the results of these projects are not distributed. As a result, most changes which are experience are positive and often isolated; when in reality they can create many widespread results.

Strategy used in the disseminating results of project to key stakeholders A number of stakeholders who are affected as result of changes which occurred due to the establishment of the new practices to reduce VAP are normally the healthcare staff of the hospital ICUs. The hospital clinical practices committee and the nurse research council is formed to inform and keep the project implementation team updated time to time. During the time of implementation, there are supposed to a weekly staff meeting where the project is discussed into details.

According to the recommendation given by Gawlinski (2007), the results obtained from the project are used in writing new guidelines, procedures and workplace competencies within the hospital ICU units. The team who are involve in the hospital wide internet to share the result of the project implementation to every clinician in the hospital. However,.