The purpose of this paper is to ensure that the standardization of best practices in the management of ventilated -associated pneumonia patients using ventilator bundle are well implemented to ensure a more efficient and high quality form of patient care…
The overall goal of this paper is to describe how is to prevent ventilator associated-pneumonia using ventilator bundle in the long term care. The focus area is the ventilator unit of Four Seasons Nursing Home and Rehabilitation Center that comprises 35 beds. The center has its location at Rockaway Parkway, Brooklyn, New York. This involves a premiere facility that offers unparalleled medical care to the residents. They offer a wide range of services, i.e. short-term rehabilitation, long-term care, adult day health care, and the post hospital treatment, in which case they provide for an original blend of professional and exceptionally skilled nursing care that they deliver with compassion and devotion. They serve the needs and lifestyles of the community.
At the end of my practicum project, I will be able to:
1. Determine what practices are used by long term care to prevent ventilator –associated pneumonia (VAP)
2. Develop a learning module for nurses on ventilator bundle for the prevention of ventilator –associated pneumonia (VAP).
3. Review and update the existing ventilator bundle protocol for the prevention of ventilator-associated pneumonia in long term care.
4. Develop a sustainable prevention program for the prevention of ventilator-associated pneumonia (VAP) in long term care....
The prevalence shows 22.8% for these kinds of clients. The danger to acquiring the actual pneumonia is found to go higher by10 fold in those who are under mechanical ventilation. Morbidity and mortality, hospital length of stay, and costs have all been attributed to VAP (Augustyn, 2007). The early onset VAP is in the first 3-4 days during mechanical ventilation while the late onset occurs for a period more than that. Early onset VAP is commonly caused by antibiotic-sensitive community acquired organisms like streptococcus pneumonia, haemophilus influenza, and styphylococcus aureus. Late onset of VAP is commonly caused by antibiotic resistant nosocomnial organisms like pseudomonas aeruginosa, methicillin-resistant staphylococcus aureus, acinebacter species, and enterobacter types. (Collard, et al.). This type of nonsocomial pneumonia, VAP, is a condition that requires a sensitive approach to the safety of critically ill clients. The American Association of Critical Care Nurses (AACN) has designed some measures critical to handling these conditions. They are designed according to specific formats of best practices for those getting mechanical ventilation. These steps are considered feasible, safe, and cost effective for preventing VAP which include; 1.) Elevation of the head of the bed (HOB) to 30 to 45 degrees unless medically contraindicated. 2.) Continuous removal of subglottic secretions. 3.) Change of ventilator circuit no more often than every 48 hours 4.) Washing of hands before and after contact with each patient. 5.) Consistent oral care. 6.) DVT and stress prophylaxis (De los Reyes, et al. 2007). Ventilator-associated pneumonia (VAP) in a seriously ill patient considerably increases the risk of ...
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The most significant clinical and economic impact of ventilator related lung infection is that a very large percentage of the population will develop this type of infection after oral intubation. Evidence-based research has shown that with some very simple basic mouth care techniques along with additional protocols, the number of patients diagnosed with ventilator associated pneumonia can be drastically reduced; normally within the first 24 hours of mechanical ventilation.
The VAP bundle includes four components of care and they are: 1. Elevation of the head of the bed of the patient This is the most integral part of VAP bundle and has been strongly associated with decrease in the rate of VAP. The elevation level that is recommended is 30-45 degrees.
It is a disease of the lung tissue occurring forty eight hours after procedures like tracheostomy or placement of an endotracheal tube to the patient is done. These procedures impair the integrity of the respiratory tree (CDC, 2012). Various journals have been published on other various VAP issues affecting its severity and outcome.
Ventilator acquired pneumonia (VAP) is pneumonia that occurs in patients on endotracheal intubation or tracheostomy tube after 48 hours or more which was not originally present before the ventilation. It is the most common ICU infection and the most fatal of all.
VAP is the commonest type of nosocomial infection, occurring forty eight hours after the initiation of mechanical ventilation. It affects between 10 to 20% of patients under mechanical ventilation. VAP leads to increased ventilator duration, increased hospital stays, increased mortality and increased cost.
Ventilator Associated Pneumonia (VAP) refers explicitly to nosocomial bacterial pneumonia that has developed in patients who are under mechanical ventilation. VAP can be segregated into two types – early onset pneumonia and late onset pneumonia. One that occurs within 48 to 72 hours after tracheal intubation and is mostly the result of aspiration is termed early onset VAP and the one that occurs after this period is termed late-onset pneumonia (Kollef, 2005).
Early onset of pneumonia is caused by infection of staphylococcus, haemophilus or streptococcus gram-positive bacteria. These strains of bacteria are antibiotic sensitive. The late onset of VAP occurs after 72hours of ventilation (Booker et al., 2013). Methicilin resistant staphylococcus, pseudomona and enterobactor bacteria normally cause it.
The main reason the patients on ventilator needs to be monitored and managed with dexterity is ventilator associated pneumonia (VAP), which adds to the morbidity and mortality statistics associated with ventilator management and hence this condition needs to be prevented (Fagon et al., 1996).
This becomes more relevant in a district hospital working in the capacity of a critical care nurse, where supports from the specialist care professionals are less available, and where the nurses in the critical care need to take clinical decision on their own (Walsh et