Preventing Ventilator Associated Pneumonia in Children Essay

Critically ill patients that require mechanical ventilation are at risk of developing secondary infections that may increase length of stay and possibly even morbidity. This fragile patient population requires special attention and meticulous adherence to established nursing standards of care. These standards of care are founded on evidenced based practices. It is important that nurses receive education about why these standards are in place and what consequences can result due to not following the established care protocols.

Pneumonia is classified according to the organism causing the infection and where the infection was acquired. Community-acquired pneumonia is contracted by individuals with minimal contact with health care facilities – such as a hospital, nursing home, or rehabilitation facility – and contract the infection by people in the wider community (MedlinePlus, 2016). Hospital-acquired pneumonia and ventilator assisted pneumonia, can be caused by a wide variety of bacteria and other organisms that can originate from the health care environment (Oxford Journals, 2016). Pneumonia that develops whilst an individual is in hospital, can be extremely severe and is more likely to be fatal. This is due to the fact, that individuals within a health care setting, often already have a serious illness, causing a weakened immune system. Also, the types of bacteria present in hospitals, are often more dangerous and resistant to treatment – then the bacteria found in the outside community (MedlinePlus, 2016). Aspiration pneumonia – or anaerobic pneumonia - results after the inhalation of a foreign matter into the lungs. If foods, liquids, saliva, or vomit make their way into the airways or lungs, instead of the oesophagus and stomach, it can cause aspiration pneumonia. It is more likely in individuals with a disturbed gag reflex – commonly due to having a brain injury or being under the influence of drugs or anaesthetics (MedlinePlus,

The prevention of VAP through standardized care can reduce mortality rates, reduce mechanical ventilation days, and decrease costs and improve patient outcome.

According to Hunter (2012, p.40) “VAP is a hospital acquired pneumonia that occurs 48 hours or more after tracheal intubation or acute tracheostomisation”. VAP is one of the most common nosocomial infection responsible for one third of mortal respiratory infections in European ICUs (Adib-Hajbaghery et al. 2011).

To encourage physicians, ICU nurses, and respiratory therapist to use the ventilator associated pneumonia bundle in all ventilated patients in an intensive care unit.

This paper explores Pneumonia and the respiratory disease process associated with bacterial and viral pathogens most commonly located in the lung. The paper examines the process, symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to educate the reader and to warn of the

Ventilator - associated pneumonia (VAP) is the second most common hospital acquired infection (HAI) and is associated with high morbidity and mortality rates for ventilated patients in intensive care units (Bingham, Ashley, Jong, & Swift, 2010). The VAP increases patients’ mortality rates, length of stay and hospital costs (Hiner, Kasuya, Cottingham, & Whitney, 2010). The VAP is the leading causes of death due to nosocomial infections and the

BiPAP is a form of noninvasive mechanical ventilation used on patients that have acute respiratory failure. Many of these patients go on noninvasive ventilation due to COPD exacerbations that are infectious, with congestive heart failure, and ventilator parameters based on their clinical assessment and changes in arterial blood gases. Two different studies were conducted on COPD patients, using a BiPAP machine to improve exacerbations and their activities of daily living. There are many positive outcomes for using these noninvasive ventilators however when used incorrectly, negative outcomes or not changes at all are always possible.

Even though the consequence of saline instillation on a ventilator patient in the acute care setting is pneumonia or the patient may become hemodynamically unstable, this practice remain contentious, the practice of this procedure will also decrease the oxygenation. (Ayhan, et al., 2015),

Ventilator-associated pneumonia is a bacterial infection that occurs in the lower respiratory system within the first 48 hours of endotrachal intubation (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). Although any hospital patient is susceptible to pneumonia, ventilator dependent patients are at the highest risk of acquiring pneumonia. The purpose of this paper is to identify the risk factors, incidences, and preventions of ventilator-associated pneumonia (VAP) using a quantitative research study performed in Malaysia. “The aim of this

Clinical problem: Oral care and ventilator-associated pneumonia (VAP) is extremely important in all healthcare organizations and has gained increased attention. For this reason, oral care has been introduced in many hospital settings. However, there is not enough evidence on critically ill patients concerning the effect of oral care interventions on the development of VAP. In order to evaluate the effect of oral care on VAP for hospitalized patients, additional studies are required.

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

is currently the second most common nosocomial infection in the United States and is associated with high mortality and morbidity (Seymann, 2008). This paper is a case study of a 52 year old female who was in the hospital for a scheduled gastric bypass surgery. During a post-op test she aspirated dye thus beginning the process of her developing nosocomial pneumonia. The patient was discharged only to return to the emergency department the following day presenting with signs and symptoms of pneumonia. This paper will discuss her diagnosis, treatment, risk factors, nursing care, socioeconomic influences, and diagnostic

The patient's overall symptoms and lab work suggest that she is suffering from hospital acquired pneumonia. Currently the patient is presenting a moist chesty cough. Additionally, her heart rate is elevated, her oxygenation is low, and her RR is high. She has a raised white blood cell count, which indicates infection. Finally, the patient is acting confused and disoriented, which can be the direct result of a lack of oxygenation to the brain. All of these symptoms point to pneumonia (Torres, 1999).