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Hospital acquired pneumonia clinical case
Literature review on hospital acquired infections
Literature review on hospital acquired infection
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Recommended: Hospital acquired pneumonia clinical case
In this day and age, the general population assumes that when someone is hospitalized the risk for getting a new infection while in the hospital is minimal. However, in the United States the risk for gaining a hospital-associated infection has become a serious concern and a costly one at that. The Center for Disease Control and Prevention has reported that hospital-associated infections have cost an estimate of 35.7 to 45 billion dollars to United States hospital when 20% of these infections could have been preventable with the correct interventions. One of the most common hospital-associated infections has become hospital-acquired pneumonia. (Scott II, 2009) This type of pneumonia is easily preventable if healthcare workers would comply with a few simple …show more content…
It is caused by the inhalation of organisms or irritants that move into the alveoli when the immune system is not strong enough to combat it. Once these organisms or irritants enter the lungs, they reach the alveoli where they begin to multiply. This multiplication of these organisms results in white blood cells traveling into the area subsequently causing local capillaries to become edematous, leaky, and to create exudate. The combination of this results in thickening of the alveolar wall due to fluid collection within and around the alveoli. Impaired gas exchange, which is the decrease in the amount of oxygen that is able to enter the lungs due to the fluid, also causes a decrease in the amount of oxygenated blood moving throughout the body. Pneumonia is usually first recognized by the signs and symptoms of shortness of breath, coughing, thick sputum, chest pain, fatigue, fever, and headache. Pneumonia can occur lobar meaning that it can occur in one segment or one entire lobe of the lung creating consolidation in that lobe. (Ignatavicius & Workman, pp.
Baptist Memorial Hospital is in a highly competitive healthcare environment. This capitation is not only the result of efforts of the other healthcare organizations but, also driven by patient consumerism. The government sponsored hospital compare website allows potential patients the ability to compare our clinical outcome data. The targeted group is also the group with the greatest healthcare choice, our medicare population. One of the major reporting categories is Hospital acquired condition, the most significant of these is hospital aired infections. The significance of the website data is:
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
The risk of this Public Health dilemma is that if M.R.S.A. is becoming even more dominant in hospitals what is preventing this epidemic from expanding to an even more dangerous ...
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Interestingly, two studies of the four compared the compliance rates of HCWs in particular nurses and physicians. Sharma, Puri, Sharma, & Whig (2011) found in their study that compliance rates for hand hygiene protocols was significantly higher for physicians (50.8%) as a opposed to nurses (41.3%). In contrast, Mathai, George, & Abraham (2011) had conflicting findings in which higher compliance rates were associated with nurses (45%) in comparison to physicians (17%). Both studies had similar sample sizes and were investigated in developing countries India and Pakistan; nonetheless, language barriers and varying educational levels of different staff groups, may have influenced the understanding of the need for effective hand hygiene (Mathai et al., 2011). Of four studies, three were observational studies, which provide opportunity to question the rigour of the
The role of nurses in the prevention of MRSA in the hospitals cannot be overemphasized. The prevalence of MRSA in hospitals calls for awareness and sensitization of all party involved in patient caregiving in the hospital. According to Wilkinson and Treas (2011), nurses take on many roles in the hospital: a caregiver, advocate, communicator, leader, manager counsellor, change agent and an educator. (Wilkinson &Treas. (2011) p.13.) The target of healthy people 2020 is to reduce MRSA and all other hospital acquired infection by 75% in the year 2020. (Healthy people 2020) This cannot be achieved without the maximum support of nurses because nurses have regular one on one contact with patients on daily basis.This paper will take a closer look at the role of a nurse as an educator in the prevention of MRSA in the hospital. One of the nurse’s roles in the prevention of MRSA in hospitals is patient/visitor/staff education.
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
Secondary:Curtis, L. (2008). Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20
Pneumonia is an inflammatory process of the lung parenchyma, usually infections in origin. Pneumonia causes your lungs by filing extra mucus and become inflamed. Which could decrease the lungs ability then normal lungs to take in air (Eagan pg. 506). Pneumonia is separated in three different classes and they are Community acquired Pneumonia which is also known as (CAP), Nosocomial pneumonia or Healthcare associated pneumonia and hospital acquired pneumonia, which is also known as (HCAP) and ventilator Associated pneumonia. Pneumonia is one of the most common infection requiring hospitalization. Pneumonia causes the bronchioles and the alveoli to fill with excess mucus and become inflamed.
Hospitals, long term care facilities, and mental health all serve as healthcare arenas serving the population in various ways. The hospital provides the most critical type of care, for the seriously ill. Hospitals originally served the poor and ill, but over time with the progression of technology and medical service specialties, they have grown to become healthcare meccas with many outlets. Over the past 30 years the degree of rigor of clinical practice and the scope of scientific knowledge has escalated greatly, and the hospital has become a center of high standards, scientific applications, and advanced technological capability (Williams & Torrens, 2008). The increasing shift of services to an ambulatory care arena facilitated by technological advancement itself has left the hospital with an evermore complex base of patient care, higher acuity, and higher costs (Williams & Torrens, 2008). Markets have changed, pricing pressures have increased, and consumer and payer expectations have evolved for hospitals, changes are constant in the medical arena, and hospitals are no exception.
The purpose of his article was to find a better way to prevent healthcare-associated infections (HCAI) and explain what could be done to make healthcare facilities safer. The main problem that Cole presented was a combination of crowded hospitals that are understaffed with bed management problems and inadequate isolation facilities, which should not be happening in this day and age (Cole, 2011). He explained the “safety culture properties” (Cole, 2011) that are associated with preventing infection in healthcare; these include justness, leadership, teamwork, evidence based practice, communication, patient centeredness, and learning. If a healthcare facility is not honest about their work and does not work together, the patient is much more likely to get injured or sick while in the