Ventilator Assisted Care Case Study

The hospital readmission (HR) may be regarded as an indicator of the quality of hospital care and, indirectly, of primary care. Some factors may foster HR, such as low quality of supportive care, early discharge, lack of treatment adherence on the part of users and their families, age, absence of

Running head: A QUALITATIVE ANALYSIS OF CLINICIANS' PERCEPTION OF A Qualitative Analysis of Clinicians' Perception of Head-of-Bed Elevation Jolly Abraham Grand Canyon University NRS-433V January 09, 2011 A Qualitative Analysis of Clinicians' Perception of Head-of-Bed Elevation 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

TABLE 1. Office Emergency Equipment and Supplies Airway management     Oxygen-delivery system E     Bag-valve-mask (450 and 1000 mL) E     Clear oxygen masks, breather and nonrebreather, with reservoirs (infant, child, adult) E     Suction device, tonsil tip, bulb syringe E     Nebulizer (or metered-dose inhaler with spacer/mask) E     Oropharyngeal airways (sizes 00–5) E     Pulse oximeter E     Nasopharyngeal airways (sizes 12–30F) S     Magill forceps (pediatric, adult) S     Suction catheters (sizes 5–16F) and Yankauer suction tip S     Nasogastric tubes (sizes 6–14F) S     Laryngoscope handle (pediatric, adult) with extra batteries, bulbs S     Laryngoscope blades (straight 0–4; curved 2–3) S     Endotracheal tubes (uncuffed 2.5–5.5; cuffed 6.0–8.0) S     Stylets (pediatric, adult) S     Esophageal intubation detector or end-tidal carbon dioxide detector S Vascular access and fluid management     Butterfly needles (19–25 gauge) S     Catheter-over-needle device (14–24 gauge) S     Arm boards, tape, tourniquet S     Intraosseous needles (16, 18 gauge) S     Intravenous tubing, microdrip S Miscellaneous equipment and supplies     Color-coded tape or preprinted drug doses E     Cardiac arrest board/backboard E     Sphygmomanometer (infant, References Baker, J & Baker, R.W. (2011) Health Care Finance, Basic Tools for Nonfinancial Managers (3rd Edition). Jones and Bartlett Publishers.

Impact of Oral Care on Mechanically Ventilated Patients Tiffany Saunders Tennessee Wesleyan University 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.

TARGET POPULATION • Adult patients on ventilators in the intensive care units (ICU) IMPLEMENTATION RECOMMENDATIONS: For successful implementation and better outcomes: • Adequate qualified medical staff must be present in all critical care areas caring for mechanically ventilated

The facility provides medical care for children and adolescents with severe physical and intellectual impairment conditions. The TWSCCC provides 24-hour skilled nursing care, 24-hour Respiratory Therapy services, Physical, Occupational, and Speech Therapy, Licensed On-site teachers, and a large variety of specialty care services (Truman W. Smith). The facility offers a viable and solicitous option for parents who are unable to take of their chronically ill children in their home, and for children who have been placed in state custody. The TWSCCC allows patients to receive the care they need and might otherwise not receive, in an adequately equipped facility via a staff of specialized care providers who advocate for the patients wants, rights, and well-being. The TWSCCC facility welcomes residents regardless of race, gender, religion, or economic status.

The team will navigate patients through the program, resources and pulmonary rehabilitation. The registered nurse will meet with the patient prior to discharge to evaluate and refer them to the appropriate services along with the social worker, which may find alternative way to pay for patients medication and other support services that may be offered. The nurse practitioner and the respiratory therapist will see the patient within 48 of hours upon admission into program. The nurse practitioner and respiratory therapist will evaluate the needs at home and enroll the patient in pulmonary rehabilitation, which will be part of the care offered to all patients. Resources for the patient will consist of a 24-hour hotline for patients who may need to seek medical advice prior to going to the emergency room. Patient will be supplied with emergency medications for home use if symptoms begin to appear. A nurse practitioner will be available to advice the patient in intervention with the emergency medications is indicated and advice if treatment may need to be continued in the emergency room. With the protocols in place for medications, the patient will be seen within 12 hours if use of the emergency medications were taken in the home. The nurse practitioner will update the electronic medical chart of the patient to document

Ventilator-Associated Pneumonia: A Quantitative Research Study Vanesia Davis Kelly Grand Canyon University Intro to Nursing Research-NRS/433V April 15, 2012 Ventilator-Associated Pneumonia 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

Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).

The American Association for Respiratory Care is a non-profit organization which provides numerous resources for registered respiratory therapists all over the United States. Membership through the AARC renders an abundance of incentives such as professional development, respiratory care education, social networking opportunities, continuing education programs and much more. The American Association for Respiratory Care truly believes in the cause of respiratory therapy and in the rights of their patients to receive competent respiratory care. Their advocacy team works with local, state and federal governments concerning public policies that affect their patients as well as their profession.

Communication is a tool that nurse leaders should master in order to send information, perception and understanding to achieve work activities and goals. Effective communication involves frequent, clear, and direct messaging of thoughts and ideas. The three elements leaders should include in creating and enhancing effective communication are trust,

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

One prospective randomized trial compared the effectiveness of ECLS with conventional mechanical ventilation (CMV) in full-term newborns with severe respiratory insufficiency. This was a randomized prospective study performed by O’Rourke (1989) which demonstrated a significant difference in survival between neonates managed with ECLS (97%) and those managed by conventional means (60%). Other studies have demonstrated a significant increase in survival among pediatric respiratory failure patients managed with ECMO when compared to matched patients managed with CMV.

I am particularly interested in working with Professor Jessica Keim-Malpass and professor Elizabeth Epstein research groups. I think my previous academic education in pediatric nursing and working in an intensive care unit for two years prepared me better for their research groups. I have also worked on various research projects that the population under the studies were children and I found working with them very interesting. To discuss some of the problems and issues that particularly engage my mind, there are lots of them, but I can mention problems of children with ventilator therapy such as their issues to speak and communicate, their parent concern and ethical issues related to it, finding ways to decrease tracheal infections, decreasing

Study design Qualitative methodology is appropriate with this study because researchers focused on the satisfaction level of the caregiver and patient in addition to the time spent preparing and administering respiratory therapy and cost of treatment. The research doesn’t appear to infer or explain the actions or experiences of the participants, but rather uses supportive data acquired by post hospitalization survey to support the validity of the study.