Ventilator Associated Pneumonia

A prospective, matched cohort study was conducted to evaluate the attributable morbidity and mortality of VAP in intensive care unit (ICU) patients. One hundred and seventy-seven patients developed VAP and stayed in the ICU for 4.3 days longer and had a trend toward an increase in risk of death

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).

During the surveillance, data from nursing documentation, physician progress notes, laboratory results, and direct observations. Data was collected from the time of admission until the diagnosis of VAP was made. The patients who were discharged from the ICU and sent to a regular medical surgical floor were followed for an additional 48 to ensure that VAP would be detected that manifested after the discharge.

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.

Broad spectrum antibiotics and antifungals should be exectuted within 4 hours of patient’s arrival to hospital with signs of sepsis per Early Goal Directed Therapy protocol. The use of vancomycin, amoxicillin/ clavulanate or a cephalosporin such as ceftriaxone as broad spectrum antibiotic drugs. A change in medications is necessary once the bacterium determination is made. Side effects of these drugs include ototoxicity, nephrotoxicity and intestinal bleeding. The nurse must assess for signs of anaphylaxis as these drugs carry high

Ventilator-associated pneumonia is defined as pneumonia occurring more than 48 hours after patients have been intubated and received mechanical ventilation. Diagnosing VAP requires a high clinical suspicion combined with bedside-examination, radiographic-examination, and microbiologic analysis of respiratory secretions. Aggressive surveillance is vital in under-standing local factors leading to VAP and the microbiologic milieu of a given unit. Judicious antibiotic usage is essential, as resistant organisms continue to plague intensive care units and critically ill patients. Simple nursing and respiratory therapy interventions for prevention should be adopted. (para.2)

(Tortora, Funke, & Case, 2013, p. 414) Most hospitalized patients will be immune compromised to some extent and the hospital, by nature, is a pathogen rich environment. Ongoing efforts to minimize pathogens in the environment by all hospital employees, patients and visitors are crucial. Infection control nurses and/or committees should work continuously to identify and eradicate possible infection sources. Equipment, especially respirators and humidifiers must be kept scrupulously clean lest they become reservoirs for microbial growth. (Tortora, Funke, & Case, 2013, p. 417) Strategically placed signs warning visitors to avoid entering the hospital if they are unwell, strict compliance with standard precautions, private rooms and special ventilation systems for contagious patients are all essential in the effort to minimize contamination. Occasionally, airborne and droplet precautions are necessary, but most pathogens responsible for common HAIs are spread by direct or indirect contact. Chain of transmission is therefore the parameter over which nurses have particular influence, as nurses have the most direct, hands-on contact with

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.

Ventilator-associated pneumonia is the leading cause of death out of all hospital-acquired infections. Pneumonia that is acquired 48 hours or longer after at patient has been mechanically ventilated is considered hospital acquired. Endotracheal tubes provide pathogenic microorganisms’ with a direct access to the lungs where they can easily set up shop and cause deathly consequences for patients’ in the acute care setting. For example, the mortality rate of patients who have ventilator-associated pneumonia is 46% whereas unaffected intubated patients mortality rate is 32%. When ventilator-associated pneumonia (VAP) occurs in a patient(s), it often increases the amount of days a patient is on the ventilator and increases their overall hospital stay (Safe Care). The big problem with this is that VAP is costing hospitals

The mission of this nursing journal is to provide research and education related to infection control, epidemiology, quality, disease prevention, and disease management (American Journal of Infection Control, 2017). This nursing journal’s mission and content is relevant in relation to CAUTI, and patient care practices provided by professionals noted within the target audience below. Combating healthcare associated infections requires a collaborative effort from every member of the healthcare team (Rabideaux, 2013). Each member of the team being accountable for their actions and contributions toward reduction of CAUTI and all hospital associated infections (Loughlin, et al.,

Ventilator associated pneumonia (VAP) is a nosocomial infection occurring in hospitalized patients who are mechanically ventilated. These infections are common in ICU settings, difficult to diagnose early, and unfortunately have a high rate of mortality and morbidity. VAP accounts for almost half of infections in ICU settings, up to 28% of mechanically ventilated patients will develop VAP and of these patients the mortality rate is between 20% and 70% (Craven & Steger, 1998). A patient that develops VAP while mechanically ventilated adds days to his recovery as well as thousands of dollars to the care costs. Numerous studies have been conducted across the county in an effort to understand VAP, however very few of those studies focus on

According to studies from both developed and limited-resource countries, the most important clinical consequences due to VAP have increased death rates, significant disease, increased the length of stay, and additional health care costs. Although hospitals in limited-resource countries do implement infection control programs, agreement with infection control practices is inconsistent. A multicenter, potential, before-after observation study was conducted using International Nosocomial Infection Control Consortium Surveillance Online System. (V.D. Rosenthal et al/American Journal of Infection Control

Our study has some limitations. First, we did not attempt to verify the accuracy of a diagnosis of VAP. Notwithstanding, this metric reflects the real life situation, at least in our relatively resource limited setting. Second, we followed all patients only till discharge. We do not know if patients died soon after discharge, either at home or in another hospital. Third, the respiratory samples were obtained by blind endotracheal aspiration, and quantitative cultures could not be done on tracheobronchial microbiological aspirates, due to the limitation of resources. We might have overestimated the incidence of VAP infection. Fourth, although all ventilated patients had their head elevated to 30°, we did not consistently use other components of VAP bundle

The Cost of Pneumonia Care of Medicare patients remains high and is effecting Summa’s quality ratings.

This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia.