Running head: SEDATION VACATION IN THE PREVENTION OF VAP Daily Sedation Vacation in the Prevention of Ventilator-Associated Pneumonia Melvies Wambo Walden University Essentials of Evidence-Based Practice NURS-6052 May 4, 2017 1
Running head: SEDATION VACATION IN THE PREVENTION OF VAP Abstract Ventilator-associated pneumonia is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU). VAP is a major source of increased illness and death. Persons with VAP have increased lengths of ICU hospitalization and have up to a 20-30% death rate. Patients in the intensive care unit (ICU) are at risk for dying not only from their critical illness but also from secondary processes such as nosocomial infection. Pneumonia is the second most common nosocomial infection in critically ill patients, affecting 27% of all critically ill patients. It is also the second most common nosocomial infection. The intervention to prevent ventilator-associated pneumonia has been a concern for years. The proper interventions, such as daily sedation vacations (DSVs), may lead to a faster recovery time, shorter length of stay (LOS) in hospitals, early extubation from the ventilator, prevent the occurrence of VAP, and decrease medical costs. This study analyzes the appropriate interventions that have been proven to reduce the occurrence of VAP. It also seeks to answer the research question; will a daily sedation vacation decrease the probability of acquiring VAP in mechanically ventilated patients. Once the evidence-based practice is identified, it must then be applied to nursing practice to be beneficial to the patients. The purpose of this paper is to determine if daily sedation vacations in the reduction of ventilator-associated pneumonia and to analyze the literature, determine what is currently known about this topic, identify holes in the research, and provide a literature review on the prevention of VAP. I will also consider how the evidence gathered in the literature review can be applied to nursing practice. 2
Running head: SEDATION VACATION IN THE PREVENTION OF VAP Daily Sedation Vacation in the Prevention of Ventilator-Associated Pneumonia (VAP) is a form of pneumonia that occurs in the first 48 to 72 hours following endotracheal intubation, characterized by a new or progressive infiltrate, fever, changes in white blood cell count (WBC), and variations in sputum characteristics (Kalanuria, Zai, & Mirski, 2014). In general, pneumonia affects 27% of all critically ill patients and is the second most common nosocomial infection; 86% of nosocomial pneumonia are associated with VAP (Koenig & Truwit, 2006). VAP increases morbidity and mortality rates, lengths of stays (LOS), and incremental costs associated with VAP (Koenig & Truwit, 2006). Research has shown that daily interruptions of sedation has decreased the number of mechanical ventilation days and decreased the length of stay in ICU (Munro & Ruggiero, 2014).
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