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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
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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.
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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).