5.Does the number of patients with VAP decrease when providing daily sedation vacations?
Sedation Vacation in the Prevention of VAP4When selecting a research question, there are four considerations to think of: the problem’s significance, researchability, feasibility, and interest to you [Pol12]. The question I have chosen as my research question would be, “Will a daily sedation vacation decrease the probability of acquiring VAP in mechanically ventilated patients?” When evaluating the significance of the problem you have to determine if it is relevant to nursing and the patients [Pol12]. This issue is relevant to nurses because it is an intervention we can perform to benefit our patients who are mechanically ventilated and potentially prevent them from acquiring a deadly illness. With feasibility you have to evaluate several issues: time, researcher experience, availability of study participants, the cooperation of others, ethical considerations, facilities and equipment, and money [Pol12]. This study is feasible because it can be completed promptly, the resources and patients are available, and the complexity of the topic is low. As a researcher, you also need to have a general curiosity for the research problem and be enthusiastic in the project [Pol12]. This topic is of interest to me because my facility recently had a new ventilator protocol initiated. PICOT Question and KeywordsFor this research question, my PICOT question would be, “In ventilated ICU patients, how does a daily sedation vacation compare to no sedation vacation influence the prevention of ventilator-associated pneumonia over a five-day period?” PICOT stands for P (patient, population, or problem), I (intervention, prognostic factor, or exposure), C (comparison), O (outcome), and T (time) [Wal152]. My population is ventilated ICU patients, the intervention would be a daily sedation vacation, the comparison would be no sedation vacation, the outcome would be the prevention of ventilator-associated pneumonia, and time would be a five-day period. Patients who have who been intubated within 48 hours meet criteria to be participants in this study.
Sedation Vacation in the Prevention of VAP5When conducting a literature search for the PICOT question, it is imperative to use keywords that will formulate appropriate articles for your research. Ten keywords that could be used for researching articles relevant to this topic are ventilator-associated pneumonia, sedation vacation, ventilator, sedation, weaning trials, mechanical ventilation, prevention, intervention, protocol, and nursing. I chose these keywords because they are all related to mechanical ventilation, ventilator-associated pneumonia, and sedation vacations. Using these keywords alone and a combination of them resulted in hundreds of articles related to my PICOT questions.Literature ReviewOccurrence of VAPVAP is responsible for roughly 300,000 cases of ICU-acquired infections per year[Cha15]. The development in VAP occurs between 10% and 20% of patients who are ventilated for 48 hours or more [Spe16]. In developed countries, VAP rates range from one to four cases per
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- Fall '16
- Randomized controlled trial, Evidence-based medicine, Case-control study, Intensive care medicine