Ventilator Associated Pneumonia in the Icu
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 the nursing interventions that can prevent this deadly and costly nosocomial infection. Many of these studies focus on the “bundling” of certain interventions, so the question is does the implementation of a VAP bundle compared with the use of non-bundled interventions decrease the incidence of VAP in ventilated patients. The research that was found in nursing journals along with a related study from a medical journal follows. Cason, Tyner, Saunders and Broome (2007) conducted a study of 1200 critical care nurses and the results demonstrate the variability in the recommended and reported care of the ventilated patient. Their study aims to identify the areas of needed improvement to comply with the CDC recommendations for prevention of VAP. The study consisted of a questionnaire distributed to nurses who attended the 2005 American Association of Critical Care Nurses National Teaching Institute, with the findings demonstrating a need for more education and research in the area of preventing ventilator associated pneumonia. Ferrer and Artigas (2001) also noted the lack of compliance in even the most basic of preventative measures. The study focuses on non-antibiotic preventative strategies for VAP; they suggest the use
References: Cason, C. L., Tyner, T., Saunders, S. & Broome, L. (2007) Nurses’ implementation of guidelines for ventilator-associated pneumonia from the Center for Disease Control and Prevention Craven, D. E., Steger, K. A. (1998) Ventilator-associated bacterial pneumonias: Challenges in diagnosis, treatment, and prevention Ferrer, R. & Artigas, A. (2001) Clinical Review: Non-antibiotic strategies for preventing ventilator-associated pneumonia Hunter, J. D. (2006) Ventilator associated pneumonia. Postgraduate Medical Journal, 82, 172-178 Labeau, S., Vandijck, D.M., Claes, B., Van Aken, P., Blot, S.I. & on behalf of the executive board of the Flemish Society for Critical Care Nurses (2007) Critical Morrow, L. E. & Shorr, A. F. (2008) The seven deadly sins of ventilator-associated pneumonia Siempos, I.I., Vardakas, K.Z., & Falagas, M. E. (2008) Closed tracheal suction system for prevention of ventilator-associated pneumonia Tolentino-DelosReyes, A. F., Ruppert, S.D., Shiao, S.P.K. (2007) Evidence-based practice: Use of the ventilator bundle to prevent ventilator-associated Ventilator-associated pneumonia. (2008). Critical Care Nurse. Retrieved from http://ccn.aacnjournals.org