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Running Head: EVIDENCE BASED PRACTICE TASK 2 Nursing Education: Ventilator Associated Pneumonia Prevention Lori Parisi 6/24/2019 Western Governors University
EVIDENT BASED PRACTICE2 A1. Healthcare Problem Ventilator associated pneumonia is the second most nosocomial infection identified in the intensive care population and is also one of the leading causes of death in the Intensive care unit. The majority of surgical and ICU patients will be placed on some form of ventilatory support with endotracheal intubation being the most common. Several studies have identified VAP as one of the most common healthcare associated infection that develops within 48-72 hours after the patient has been intubated and placed on mechanical ventilation support (Subramanian et al., 2018). Nursing staff is considered one the front line support personnel who can take an active role in the prevention of ventilator associated pneumonia through the use of evidence based practice guidelines and VAP bundles. The common theme noticed among multiple studies is formal lack of education to staff nurses regarding the current VAP guidelines. A2. Significance of the problem Ventilator associated pneumonia (VAP) accounts for health care cost exceeding $40,000 per patient with an increased ICU stay of 6-7 days (Atashi et al., 2017). It has been estimated that the average mortality rate is upwards of 46% and can pose significant cost to patients and healthcare systems globally (Rashnou et al., 2018, p. 174). Research articles stress the importance of VAP management and prevention. Current guidelines suggest the use of a “ventilator bundle” which include head of bed elevated by 30-45 degrees, reducing the amount of sedation required, ongoing assessment of the patient’s redness for extubation, peptic ulcer prevention, and oral care/ subglottic suctioning (Atashi e 2017).
EVIDENT BASED PRACTICE3 A3. Current practice related to the problem Current practice guidelines suggest the use of a “ventilatorassociated pneumonia prevention bundle” which include head of bed elevated by 30-45 degrees, reducing the amount of sedation required, ongoing assessment of the patient’s redness for extubation, peptic ulcer prevention, and oral care/ subglottic suctioning (Atashi et al. 2017). A qualitative study done on critical care nurses identifies several barriers that nurse’s face in the management of ventilator associated pneumonia. The major barriers in ventilator associated pneumonia prevention (VAP) were low quality of working life, poor organizational culture, reluctance to perform care measures and limited nursing staff resources (Rashnou et al. 2017). One of the recurring themes most noted was the nurses limited professional competence, inappropriate equipment and ineffective supervision. (Atashi et al, 2017).
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Nursing, Intensive care medicine, ventilator-associated pneumonia