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Ventilator associated pneumonia
Ventilator associated pneumonia essay
Ventilator associated pneumonia
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About Ventilator-associated Pneumonia Ventilator-associated Pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given be means of an endotracheal tube or tracheostomy. VAP results from the invasion of the lower respiratory tract and lung parenchyma by microorganisms. VAP may account for up to 60 percent of deaths from healthcare-associated infections in the United States. VAP an also increase the patient’s stay in the ICU by four to six days.
Relevant Statistics Ventilator-associated pneumonia is the most common and deadly healthcare associated infection, affecting up to 28 percent of ventilated patients. VAP is estimated to occur is 9-27 percent of all mechanically ventilated patients, with the highest risk being early in the course of hospitalization. VAP rates range from1.2 to 8.5 per 1000 ventilator days and are reliant on the definition used for diagnosis. Early onset VAP is defined as pneumonia that occurs within four days and this is
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There are many different ways to educate healthcare workers on VAP. This can be achieved by self-study molecules, Internet-based learning programs, lectures, small group teaching, workshops on informative posters summarizing VAP prevention guidelines. Healthcare worker should go through training in VAP prevention, and adherence to infection prevention guidelines should be monitored. A strategy utilizing a physician-led task force to educate respiratory therapists and also critical care nurses about VAP prevention strategies was shown to reduce VAP rates from 12.6 to 5.7 per 1000 ventilator days. Also, another study showed a 46 percent decrease in the rates of VAP after an educational program for the ICU nurses and respiratory therapists. (How to Prevent Ventilator Assoicated Pneumonia,
BiPAP is a form of noninvasive mechanical ventilation used on patients that have acute respiratory failure. Many of these patients go on noninvasive ventilation due to COPD exacerbations that are infectious, with congestive heart failure, and ventilator parameters based on their clinical assessment and changes in arterial blood gases. Two different studies were conducted on COPD patients, using a BiPAP machine to improve exacerbations and their activities of daily living. There are many positive outcomes for using these noninvasive ventilators however when used incorrectly, negative outcomes or not changes at all are always possible.
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...
Epidemiology of VAP Hunter, Annadurai and Rothwell defines ventialtor-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal or trascheotomy tube. It is commonly classified as either early onset (occurring within 96 hours of start of mechanical ventilation) or late onset (>96 hours after start of mechanical ventilation. A ventilator is a machine that is used to help a patient breathe by giving oxygen through an endotracheal tube, which is a tube placed in a patient’s mouth or nose, or through a tracheostomy, which is a surgical opening created trough the trachea in front of the neck. Infection may occur if bacteria or virus enters the tube into the lungs or airways by manual manipulation of the ventilator tubing. Ventilator-associated pneumonia accounts for 80% of hospital-acquired pneumonia, 8-28% of incubate... ...
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
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).
Ventilator-acquired pneumonia (VAP) is defined by the Center for Disease Control as “A pneumonia where the patient is on mechanical ventilation for >2 calendar days on the date of event, with day of ventilator placement being Day 1” (2014). Pneumonia is an unfortunate risk factor of being intubated for any period of time due to the increase chance for aspiration. Aspiration of gastric contents is a major route for bacteria to enter the lungs. Intubation increases the patient’s risk of acquiring infections compared to patients who are not intubated. The factors that might increase the patient’s chances of developing ventilat...
Education of all nurses, not just critical care nurses, of the early signs and symptoms of sepsis and quickly implementing the sepsis resuscitation bundle is crucial to decreasing the mortality rate of sepsis.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
VAP develops in a patient after 48 hours or more of endotracheal intubation. According to a study by Relio et al. (as citied in Fields, L.B., 2008, Journal of Neuroscience Nursing, 40(5), 291-8) VAP adds an additional cost of $29,000-$40,000 per patient and increases the morality rate by 40-80%. Mechanically ventilated patients are at an increased risk in developing VAP due to factors such as circumvention of body’s own natural defense mechanisms in the upper respiratory tract (the filtering and protective properties of nasal mucosa and cilia), dry open mouth, and aspiration of oral secretions, altered consciousness, immobility, and possible immunosuppression. Furthermore, the accumulation of plaque in the oral cavity creates a biofilm that allows the patient’s mouth to become colonized with bacteria.
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.
Within the Surviving Sepsis Campaign they introduced guidelines and bundles which may beused as the basis of a sepsis performance improvement program. The Guidelines were based around a six-point action plan (...
“Whoa-oa-oa! I feel good, I knew that I would now. I feel good….”. My “I feel good” ringtone woke me up from the depths of slumber during my first night call in internal medicine rotation. My supervising intern instructed me to come to the 4th floor for a patient in distress. Within moments, I scuttled through the hospital hallways and on to the stairs finally arriving short of breath at the nurses’ station. Mr. “Smith”, a 60 year old male with a past medical history of COPD was in respiratory distress. He had been bed bound for the past week due to his severe arthritis and had undergone a right knee replacement surgery the day before. During evening rounds earlier, he had no signs of distress. However, now at 2 AM in the morning, only hours later since rounds, he was minimally responsive. My intern and I quickly obtained the patient’s ABG measurements and subsequently initiated a trial of BIPAP. This resolved Mr. Smith’s respiratory distress and abnormal ABG values. To rule out serious causes of dyspnea, a stat chest x-ray and CT were obtained. Thankfully, both studies came back normal.
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung infection that occurs in a person who has been on a ventilator.... ... middle of paper ... ...
The Infection Prevention and Control (IPC) Program is an essential force maximizing quality, patient centered care, and safety throughout the Veterans Affairs North Texas Health Care System (VANTHCS). The VANTHCS “... is a progressive health care provider in the heart of Texas ... we serve more than 117,000 Veterans and deliver 1.4 million outpatient episodes of care each year to Veterans in 38 Texas counties and two counties in southern Oklahoma” (“VA North Texas,” 2016, para. 1). The purpose of the IPC Program is to guide a facility-wide approach toward identifying, preventing, controlling, and eliminating healthcare-associated infections (HAIs). This approach is facilitated through infection control (IC) practitioner’s role-modeling behaviors of assessing, supporting, guiding, and/or directing healthcare providers (HCPs) in the application of evidence-based practices (EBPs) to prevent HAIs. According to the Centers for Disease Control and Prevention (CDC), HAIs are often preventable adverse events that pose a major threat to patient safety (“Centers for Disease,” 2016). As a result, IC practitioners recognize the importance of preparing nurse faculty to engage clinical staff in the application of EBPs to prevent infections.