The Importance Of Complications In Healthcare

It has been repeatedly stated that oral care is important in the prevention of ventilator-associated pneumonia (VAP). Endotracheal intubation predisposes patients to developing VAP. The tube acts as a conduit from the mouth to the lungs – a perfect track for bacteria to descend upon. Khezeri, et al. (2014) suggest that “the presence of an endotracheal tube (ETT) inhibits normal coughing, normal swallowing, and the protection of the trachea contact by epiglottis closure.” In addition, an endotracheal tube keeps the patients mouth open – leading to dryness. Bacteria are not washed away by saliva. Also, Landgraf, et al. (2017) mention that the presence of an endotracheal tube in the mouth causes “changes in the oral epithelium” which “might indicate risk for infection in intensive care patients

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

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

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

While there was a policy in place for conscious sedation, even good policies rely on the vigilance of staff to adhere to them. Often times, working conditions allow for distractions, and even the best of practitioners, with the best of intentions, make errors. There were several areas presented in this scenario that require examination and improvement.

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

Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence

Enhanced assessment and nursing implementations to better prevent and detect ICU delirium will bring improved outcomes for this particular patient population. There are many ways to assess for ICU delirium. Two of the most reliable and easiest methods are basic observations from the bedside nurse and The Confusion Assessment Method (CAM). The CAM includes nine different criteria for delirium (1) acute onset and fluctuation, (2) inattention, (3) disorganized thinking, (4) altered level of consciousness, (5) disorientation, (6) memory impairment, (7) perceptual disturbances, (8) psychomotor agitation or retardation, and (9) altered sleep-wake cycle. A delirium diagnosis is given when criteria one and two and either three or four are present. The second assessment tool for delirium detection is made from nursing observations. The nurse observes the patient throughout their

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

Ventilated and sedated patients are unable to report pain verbally. This causes patients to unnecessarily feel pain.

In the Delirium Assessment and Management as found on the American Association of Critical-Care Nurses the organization indicate delirium is a major problem that can affect up to eighty percent of patients that are admitted to the ICU (“American Association of Critical-Care Nurses”, 2015). Additionally, complications associated with delirium such as longer LOS in the hospital and ICU as well as increased time on the mechanical ventilator increases mortality and costs which can range from “$4 billion and $16 billion annually in the US” (“American Association of Critical-Care Nurses”, 2015). In the past many health care providers and nurses gave delirium a laissez-faire attitude by assuming delirium will resolve itself when they are leave

A timeframe of about 6-month test of pilot will be completed to test the feasibility and efficacy of a protocol adoption of a bundle care for the prevention of ventilator associated pneumonia. The VAP bundle protocol guidelines will be used to determine quality management and reflective data audit for all patients admitted in the intensive care unit with mechanical intubation within this 6-month trial period. Evaluation is a systematic way of checking a project’s information on the activities, and characteristics in order to make a judgement of the project. Evaluation can help to give recommendations to the project and improve by adapting the recommendations and improve future projects. Evaluation gives managers considerable evidence to support the decision process with the well documented analysis.

Complications can follow transplantation in the recipient for some reasons. Noted first that the extraction and transplantation of vital organs require major surgery. In addition, the person suffering from organ failure may be in poor health and should also take immunosuppressants. Some complications are light and other more serious; some last a short time, while others are more chronic. Depending on the outcome of the surgery, the receiver usually stays a week in the hospital after the surgury. During this period, the transplant team closely monitors his status and tests to ensure that the new body works well and there are no serious complications. Note that a longer hospital stay may be necessary. As is the case with any surgery, there