Zap Vap
ZAP VAP
YVONNE SENTNER
WAYNESBURG UNIVERSITY
NUR589: EVIDENCE-BASED NURSING PRACTICE
NANCY STYNCHULA, BSN, RN
OCTOBER 6, 2010
INTRODUCTION Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn, 2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that by doing something as simple as swishing a drug known as Chlorhexidine around in your mouth (or for those who are ventilated, having their mouth swabbed with it) can decrease the number of VAPs and patients, hospitals and insurance companies money.
PICOT QUESTION
In patients requiring mechanical ventilation for over 48 hours, is the usage of oral Chlorhexidine solution twice daily effective in reducing Ventilator Associated Pneumonia (VAP)?
Population Any patients that are on the ventilator for over 48 hours, regardless of age, sex, or past and current medical history.
Intervention Patients on the ventilator for over 48 hours will be given Chlorhexidine to “swish and spit” to help kill bacteria present in the mouth. For patients that are extubated, the Chlorhexidine will be treated like a mouthwash. For those who are on the ventilator, the Registered Nurses (RNs) will swab out their mouth with the Chlorhexidine liquid.
Comparison There is no comparison because all patients will be given Chlorhexidine twice a day.
Outcome The outcome will prove that there will be a lower number of VAPs due to the use of Chlorhexidine treatments on all patients.
Time One year will be needed to complete this study.
KEY WORDS
YVONNE SENTNER
WAYNESBURG UNIVERSITY
NUR589: EVIDENCE-BASED NURSING PRACTICE
NANCY STYNCHULA, BSN, RN
OCTOBER 6, 2010
INTRODUCTION Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn, 2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that by doing something as simple as swishing a drug known as Chlorhexidine around in your mouth (or for those who are ventilated, having their mouth swabbed with it) can decrease the number of VAPs and patients, hospitals and insurance companies money.
PICOT QUESTION
In patients requiring mechanical ventilation for over 48 hours, is the usage of oral Chlorhexidine solution twice daily effective in reducing Ventilator Associated Pneumonia (VAP)?
Population Any patients that are on the ventilator for over 48 hours, regardless of age, sex, or past and current medical history.
Intervention Patients on the ventilator for over 48 hours will be given Chlorhexidine to “swish and spit” to help kill bacteria present in the mouth. For patients that are extubated, the Chlorhexidine will be treated like a mouthwash. For those who are on the ventilator, the Registered Nurses (RNs) will swab out their mouth with the Chlorhexidine liquid.
Comparison There is no comparison because all patients will be given Chlorhexidine twice a day.
Outcome The outcome will prove that there will be a lower number of VAPs due to the use of Chlorhexidine treatments on all patients.
Time One year will be needed to complete this study.
KEY WORDS
References: Augustyn, B. (2007). Ventilator-Associated Pneumonia. Critical Care Nurse, 27(4), 32-39. Bird, D., Zambuto, A., O 'Donnell, C., Silva, J., Korn, C., Burke, R., Burke, P., & Agarwal, S. (2010). Adherence to ventilator-associated pneumonia bundle and incidence of ventilator-associated pneumonia in the surgical intensive care unit. Archives of Surgery (Chicago, Ill.: 1960), 145(5), 465-470. Craven, D. E. (2006). Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest, 130(1), 251-260. Ganz, F. K., Fink, N. F., Raanan, O., Asher, M., Bruttin, M., Ben Nun, M., & Benbinishty, J. (2009). ICU nurses ' oral-care practices and the current best evidence. Journal of Nursing Scholarship, 41(2), 132-138 Halm, M. A., & Armola, R. (2009). Effect of oral care on bacterial colonization and ventilator-associated pneumonia. American Journal of Critical Care, 18(3), 275-278. Koeman, M., AJA, Hak, E., Joore, H., Kaasjager, K., de Smet, A., Ramsay, G., Dormans, T., Aarts, L., de Bel, E., Hustinx, W., I, Hoepelman, A. M., & Bonten, M. (2006). Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. American Journal of Respiratory & Critical Care Medicine, 173(12), 1348-1355. Munro, C. L., Grap, M. J., Jones, D. J., McClish, D. K., & Sessler, C. N. (2009). Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. American Journal of Critical Care, 18(5), 428-438. O 'Keefe-McCarthy, S. (2006). Evidence-based nursing strategies to prevent ventilator-acquired pneumonia. Dynamics, 17(1), 8-11.