Ventilator Associated Pneumonia (VAP): An Appraisal Report Grand Canyon University Professional Capstone Project December 13 2012 Presented to: Date: Ventilator Associated Pneumonia (VAP) Ventilator Associated Pneumonia (VAP) is a common nosocomial infections that affect administered with mechanical ventilation; it is responsible for most antibiotic drugs given to ICU patients…
Such infections lead a patient to spend more time in ICU and hospital; the infection is responsible for a mortality rate of about 9%. The infection is estimated to occur 48 hours, or more after the patient receives tracheal intubation. Such pneumonia infection may be early onset or when it occurs at the initial stages or late onset at the late stages of mechanical ventilation. Below is the appraisal of several studies on VAP, with their findings and study designs illustrated, and a critical review of their strengths and weaknesses where relevant. Tolentino-DelosReyes, F. A., Ruppert, D. S., & Pamela, K. S. (2007). Evidence-based practice: Use of the ventilator bundle to prevent ventilator associated pneumonia. American Journal of Critical Care, 3 (4), 12-13. http://www.ncbi.nlm.nih.gov/pubmed/17192523 The study examined the knowledge of critical care nurses related to the use of ventilator bundles in preventing VAP. It was found nurses who complied with study findings improved n their knowledge and practical performance in preventing VAP cases. The study showed that short education session can indeed improve the performance of nurses and their knowledge. The study investigated factors that contribute to VAP. It was found that VAP rate increased in in CCU patients by 4%, from 24% to 28% in the fourth day caused by high secretions. Therefore, the education program on nurses to improve their knowledge regarding the use of VAP bundles was successful and resulted to the required change in nurses’ practices (Hawe et al., 2009). Zaydfudim, V. et al. (2009). Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Archives of Surgery, 144(7), 656-62 doi: 10.1001/archsurg.2009.117. This study investigated the effects of an electronic dashboard in improving compliance in reduction of VAP rates, and bundle parameters in surgical intensive care units (SICU). It was found that dashboard intervention increased the ventilator bundle compliance in SICU from 39% to 89% after the study. Therefore, the article demonstrates that adherence to using such ventilator bundles was effective in reducing VAP cases considerably. The study investigated the relationship between use of ventilator bundles and VAP infections. It was found that compliance with ventilator bundle improved from 39% to 89% by the end of July 2008 decreasing VAP rates by about 6.0 per 1000 ventilator days, from an initial mean of 15.2 t0 9.3 per 1000 ventilator days following the dashboard intervention. Therefore use of the dashboard resulted to the required change (Zambuto et al., 2010). Hawe, S. C., Ellis, S. K., Cairns, S. C., & Longmate, A. (2009). Reduction of ventilator associated pneumonia: Active versus passive guideline implementation. Intensive Care Med. 35(7), 1180-6 doi: 10.1007/s00134-009-1461-0. Epub The article involved the use of an active multifaceted bundle aimed at improving staff compliance with evidence based practices in reducing VAP cases. A VIP prevention bundle implemented actively and integrated in staff evaluation process resulted in compliance with VAP bundle use. The article analyzed VAP incidences and both mortality and morbidity rates in ICUs. In the findings, compliance with a VAP bundle increased with implementation of active multifacet ...
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