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Running head: LITERATURE REVIEWLiterature ReviewShannon B. MangatMaryville UniversityNURS 601November 27, 2018
LITERATURE REVIEWLiterature ReviewIn patients who are critically ill, endotracheal intubation and ventilator assisted breathingare sometimes necessary to preserve life. But, as with any medical intervention, there arepotential complications associated with these measures. The most common of these beingventilator-associated pneumonia, also known as VAP. Ventilator-associated pneumonia is mostcommonly caused by the micro-aspiration of gastric content into the lungs. VAP is defined aspneumonia that occurs after a patient has been mechanically ventilated for more than 48 hours.The occurrence of ventilator-associated pneumonia increases the length of stay in the intensivecare unit (ICU) as well as the morbidity and mortality rate in those particular patients.Nosocomial infections, such as VAP, also account for a significant increase in the cost of healthcare. Pneumonia is the second leading nosocomial infection in patients who are critically ill with86% of all nosocomial pneumonias being attributed to mechanical ventilation (Koenig & Truwit,2006). There have been many research studies on the prevention of VAP and as nurses it isimportant for us to use this research as a guideline for care. Preventing VAP is not only what isbest for the patient but it also important to the facilities in which these patients are cared for. Asan ICU nurse, I have been witness to the negative outcomes associated with VAP and would loveto see the prevalence of this infection decrease tremendously. One of the leading studies on VAPis whether or not patient positioning effects the occurrence of VAP. But does it really make thatbig of a difference? This literature review will explore the evidence gathered on the subject andhopefully answer the following question. In ventilated patients, what is the effect of the semi-recumbent position on VAP compared to supine positioning?2
LITERATURE REVIEWSearch HistoryUsing the stated PICO question, a search for evidence was performed across severaldatabases. The databases utilized were MEDLINE, PubMed, the Cochrane Database of SystemicReviews, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Thekeywords used for the search were “ventilator-associated pneumonia” and “semi-recumbentposition versus supine position”. The search revealed a plethora of articles but only six articleswill be utilized for this literature review. These studies include systemic reviews and randomcontrolled trials (RCTs) performed by experts in their fields.Support of semi-recumbent positioningThree studies were chosen for review in which the results favor semi-recumbent oversupine for patient positioning. The first was a randomized control trial (RCT) conducted byresearchers Drakulovic and partners. The framework for this trial was to test the positioning

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Term
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Tags
Nosocomial infection, Randomized controlled trial, Supine position, Prone position

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