Ventilater Associated Pneumonia

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

In clinical experience, it is seen that many patients in the Intensive Care Unit (ICU) are on mechanical ventilation. These patients range from having head trauma, heart surgery and respiratory problems yet there is no clear, concise systematic standard oral care procedures noted on the different floors in the hospital. Oral care is a basic nursing care activity that can provide relief, comfort and prevention of microbial growth yet is given low priority when compared to other critical practices in critically ill patients. The Center for Disease Control reveals that Ventilator-Associated Pneumonia (VAP) is the second most common nosocomial infection that affects approximately 27% of critically ill patients (Koeman, Van der Ven & Hak,

Nardi (2012) has found the following: Ventilator-Associated Pneumonia (VAP) is the second most common Healthcare-Associated Infection (HAI) in the United States and is responsible for 25% of the infections that occur in intensive care units (ICUs). VAP is associated with increases in death rates, lengths of stay, and healthcare costs. (p. 41) As frontline caregivers and advocates for their patients, nurses need to understand the basics of VAP, risk factors for this type of pneumonia, and strategies that may avoid the

The purpose of this document is a critical study and analysis of the oral care provided by nursing staff as part of the Ventilator Care Bundle (VCB) and to assess whether the frequency of mouth care performed is related to the prevention of Ventilator Associated Pneumonia (VAP) in patients mechanically ventilated (Zilberberg et al. 2009).

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

Nosocomial infections relate directly to nursing care so nurses should understand the pathophysiology, risk factors, and prevention strategies for VAP.

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

VAP is one of the common hospitals acquired infections, which got significant importance in following evidence based practice to prevent it. The authors of this study used a retrospective single center observational cohort study, done in the ICU at Scott and White Hospital, Temple, Texas. The study took almost two years for its completion. The research team implemented the ventilator bundle about 258 patients in mechanical ventilator. The limitations of the study were its retrospective nature, single center study and the database does not have metrics for severity, such as Acute Physiology and Chronic Health Evaluation (APACHE) score.

Nurses play a significant and a very critical role in decreasing incidence of septic shock by early identification immediate treatment. The first role of the nurse starts with assessing and recognizing patients who are at risk for sepsis. According to Janice Tazbir, RN., M.S., CCRN, early recognition of sepsis could decreases the mortality rate by 25% (Tazbir, 2012) Tazbir identified, very ill patients due to an infectious agent, patients in the intensive care unit, patients with invasive devices, patients with wounds, burns, and surgeries are at higher risk for sepsis that could lead to septic shock. However, nurses must keep in mind that some patients may not always develop the same classic signs of sepsis due to the effects of different medications that they may be receiving. For this reason, prevention is the key and it starts with implementing a thorough hand hygiene, and maintaining

Purpose: The purpose of this article is to review the updated Association of Perioperative Registered Nurses (AORN) recommended practices for prevention of transmissible infections in the perioperative practice setting to help perioperative nurses apply the recommendations in daily practice.

The Ganz et al. (2009) research was performed in order to evaluate the ICU nurses oral care routines and if they were using appropriate, up-to-date evidenced based techniques and lastly if evidence-based practices (EBP) was associated with personal demographics and professional characteristics. Ganz et al. (2009) had found that previous research and studies has shown that poor oral hygiene may contribute to greater risks for pneumonia which results in an increase in mortality and morbidity (Ganz et al., p 133). In fact some of the research studies had stated that there was no documentation of the nurses oral care practices and these practices were not even up-to-date with recent evidence (Ganz et al., p 133). In addition to that, ventilator-associated

There are multiple reasons that play into patients acquiring these infections. One of those reasons being the characteristics of the patients. For example infants, the elderly, people with compromised immune systems, and patients that have devices inserted for therapeutic purposes are all at greater risk to contract an infection (Feasey & Molyneux, 2011). The devices that are inserted for therapeutic purposes are a huge factor related to hospital acquired infections. Urinary catheters are the top device to cause an infection; in fact 97% of urinary tract infections are due to catheterization. 87% of people that obtain a bloodstream infection receive the infection from a central line. Lastly 83% of pneumonia acquired in the hospital is linked to the use of mechanical ventilation (Chang et al., 2011). Then there is the health care worker side that plays into effect. One of the number one reasons an infection is created or spread is because a health care worker did not properly wash his or her hands or their patient’s hands. This seems like an obvious way to prevent an infection but yet it still remains one of the top factors that leads to a hospital acquired infection. Hand hygiene is not the only hygienic issue. Health care workers do not always follow proper personal protective equipment guidelines. They may not always don gloves when

(2012) evaluated whether oral care by swabbing with 0.2% CHX decreases the risk of ventilator-associated pneumonia (VAP) in hospitalized patients. Patients 18 years and older were included in the study if they had no episode of chemical pneumonitis and have never been diagnosed with thrombocytopenia. Eligible patients were randomly assigned to one of two groups as follows: a CHX group (n=29) and a control group (n=32). Oral care was performed by swabbing oral mucosa with either CHX or saline on sponge pellets, four times daily (at 6 AM, 12 AM, 6 PM and 12 PM). Approximately 30 mL of 0.2% CHX or saline was applied and this lasted for about 1 minute. The control group received the standard oral care (saline applications). All patients were followed for at least 14 days or until discharge from the hospital, extubation or death. The main outcome in this study was the incidence of VAP and was assessed using a mouth mirror together with a headlight. VAP was observed in 34/61 patients (55.7%) within 6.8 days. The rate of the development of VAP was significantly higher in the control group (68.8%) compared to the CHX group (41.4%) [p = 0.03] with a significant odds ratio of 3.12 (95% CI = 1.09-8.91). This study identified acinetobacter baumannii (64.7%) as the most frequent pathogen of all study

Ventilator-associated pneumonia compounds the risks that critically-ill patients face in hospitalization. It affects a high proportion of patients on ventilators and has a fluctuating morbidity rate. The goal of this paper is to demonstrate the potential usefulness of chlorhexidine in preventing ventilator-associated pneumonia in adults. The paper features a review of literature found via MedScape using the keywords “chlorhexidine,” “ventilator-associated pneumonia,” “long-term ventilation” and “prevention.” The results show that there is a positive correlation between using chlorhexidine in the oral care of patients using a ventilator; however, the evidence thus far does not present an opportunity to promote any clinical recommendations.

Promoting strategies to improve this quality measure is imperative because critically ill patients are more vulnerable and susceptible to infections. The focus of ICU’s and the nurses who work there is providing care that patients need and ensuring quality and safety. The purpose of this health care quality indicator is to help nurses and physicians reduce the occurrences of VAP, resulting in reduced mortality and morbidity among ICU patients who are mechanically ventilated, and to reduce costs for hospitals.