Download or read book Evidence based Practice Proposal written by Annette Beekham and published by . This book was released on 2010 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Evidence based Practice Proposal written by Lali Joseph and published by . This book was released on 2010 with total page 78 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Constructing the Written Evidence based Proposal Capstone Project final written by Bobina Titus and published by . This book was released on 2012 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Evidence based Proposal on Ventilator Associated Pneumonia written by Jessy Jose and published by . This book was released on 2013 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator Associated Pneumonia (VAP) is defined as an inflammation of the lungs occurring after 48 hours of endotracheal intubation and mechanical ventilation. VAP is the second most common nosocomial infection in the United States and is the leading cause of mortality and morbidity in Intensive Care Units (ICU). Preventive measures include proper hand hygiene, inclusion of evidence based practices, and education of healthcare professionals. Nurses have a vital role in the implementation of ventilator bundle practices and in reducing the risk of VAP in ICU. A time series study design with convenience sampling was utilized for the implementation of nurse initiated evidence-based practice guidelines to prevent VAP in the ICU. The study participants included all adult intubated patients on mechanical ventilation for more than 48 hours for 12 months. The study was conducted in a 22 bed ICU in a general hospital in California and a total number of 80 nurses were included in this study. Introduction of an intervention took an hour that included poster presentations and in-service education on evidence-based practices for the prevention of VAP. VAP committee, including the nurse manager, educators, ICU nurses, and an advanced nurse practitioner, were auditing the process of the project after the intervention. Evaluations of the effectiveness of VAP prevention best guideline practice is assessed by comparing the occurrence of VAP before and after implementation of the EBP guidelines. The recently implemented EBP guidelines to prevent VAP revealed a reduction in VAP rate, number of ventilator days, mortality and morbidity rates, subsequent hospital stay, and associated costs . Educational sessions provided for nurses showed an improved nursing practice related to VAP prevention strategies such as oral care, head of bed (HOB) elevation, suctioning, and hand hygiene. Nurses should be encouraged to participate in research studies in order to adopt best evidences into clinical practice, thus enhancing patient safety.

Download or read book Evidence Based Practice in Ventilator Associated Pneumonia Prevention written by Silgi Augustine and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator associated pneumonia (VAP) is among the most dangerous of all healthcare associated infections. This will add on to increased mortality, morbidity and length of hospital stay. Even though there are numerous evidence based interventions in practice to reduce VAP, there is still a gap remaining in delivering these interventions at the bedside. Education is the critical component to understand and accept the strategies to prevent this infection. The cost of patients with VAP is approximately 39000 dollars to 58000 dollars higher per incidence than the expense of a patient that did not have VAP. In addition to the healthcare cost, patients stay in ICUs 5-20 days longer than the patient who did not acquire VAP (Sedwick, Lance-Smith, Reeder, and Nardi, 2012). Prevention of this hospital acquired infection is important in maintaining a quality of health services. There are evidences from the research studies that more than 90% reduction in VAP, after the implementation of ventilator care bundle (Andrews and Steen, 2013). Literature review of all fifteen recent articles supports ventilator care bundle as an intervention to prevent VAP. Proper education will be given to each staff regarding bundle care, and the results of this implementation plan will be evaluated to measure the effectiveness and the outcomes. This paper is a summary of capstone project which supports ventilator bundle care as an intervention to prevent VAP.

Download or read book Ventilator Associated Pneumonia and Prevention Through Evidence Based Practices written by Saritha Dsouza and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on the studies conducted, patients who are on the mechanical ventilator in the ICU settings are prone to develop ventilator associated pneumonia(VAP), the most severe type of hospital acquired infection. Research has indicated that when patients aquire this infection it increases the length of stay in the ICU, increases healthcare costs and increases the mortality rates. Prevention of this infection by using evidence based practices is the responsibility of all the healthcare providers. Ventilator bundle practice protocol is when used appropriately has shown to reduce the incidence of VAP. All the components of the protocol must be used to provide quality healthcare and better patient outcomes.

Download or read book Prevention of Ventilator Associated Pneumonia written by Sharon K. Igou and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The use of ventilator-associated pneumonia (VAP) bundles including oral care in mechanically ventilated adults in the intensive care unit results in a decreased incidence rate of ventilatorassociated pneumonia. Research evidence supports the use of VAP bundles and oral care to prevent ventilator-associated pneumonia. This proposal will include an implementation plan for the initiation of a VAP bundle including oral care by way of a change in process.

Download or read book Ventilator Associated Pneumonia written by Carolyn Mullins and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator-Associated pneumonia is known to be one of the most common complications for critically ill patients on mechanical ventilation. Developing a new oral care protocol is necessary to reduce or eliminate the development of this complication. Preventing or eliminating the development of ventilator-associated pneumonia will reduce hospital length of stay, decrease hospital cost, and decrease mortality rates which are caused by this illness. Research has been conducted on the use of chlorhexidine in routine oral care practice, which has shown to be effective in reducing or eliminating the development of ventilator-associated pneumonia. Chlorhexidine has been identified as an easy and inexpensive method in providing oral care with few adverse effects. Developing an appropriate implementation plan, while following the institutions policy and procedure, will provide and show the solution to addressing this complication. One barrier in implementing a change in oral care practice may be the nurses providing the care. Nurses view oral care on critically ill patients as a comfort measure and possibly compliancy can become an issue. Providing the education necessary to nursing staff is essential for the oral care practice to be successful. The aim of this proposal is to show key stakeholders the necessity for change and to implement a new oral care protocol. The proposal will have a written implementation plan explaining how this will be accomplished and an evaluation plan to obtain information in reference to the effectiveness of the proposal.

Download or read book Ventilator Associated Pneumonia and Bundle Care written by Velta Soto and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Research studies have reported that nearly 10-20% of mechanically ventilated patients develop ventilator associated pneumonia (VAP) during their stay in the critical care unit. VAP has been recognized as one of the most common hospital acquired infections (Fakih, and others, 2013). Evidence based research has identified components for the care of mechanically ventilated patients leading to a reduction in VAP, thus leading to a reduction in patient mortality and morbidity, reduced hospital length of stay and overall reduction in healthcare associated costs. The Institute for Health Care Improvement recommended the following interventions in association of VAP reduction: elevation of the head of bed to be and≥ 30-45°, daily "sedation vacation", assessment of patient ability for weaning from ventilator and extubation, the use of venous thromboembolism prophylaxis and the use of peptic ulcer disease prophylaxis (Pinto, and others, 2011). Implementation and compliance with VAP bundle care by all nursing staff and collaborative efforts of the healthcare team can lead to an eradication and reduction of VAP infections. A proposal for implementation of VAP bundle care for the critical care units was presented to key stakeholders. This presentation includes an implementation plan, evaluation plan, and dissemination of supporting evidence for the use of VAP care bundles. The pressure ulcer prevention protocol required budget approval, chart audits to verify compliance and track outcomes, and education to the critical care unit healthcare professionals. Research findings of evidence based data was disseminated to the key stakeholders in order to institute current changes in mechanically ventilated patients, improve the quality of patient care, with an improvement in patient outcomes. Implementing VAP bundle care protocol with every mechanically ventilated patient, at the time of intubation, will lead to decreased risk of mortality and decrease the costs healthcare costs to the patient and the facility.

Download or read book Capstone written by Miranda Balster and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator associated pneumonia (VAP) bundle protocols are responsible for saving lives, decreasing mortality rates, limiting length of hospital stay, avoiding prolonged mechanical ventilation and preventing added hospital costs. Throughout the world, VAP bundle protocols have been initiated successfully in order to increase patient outcomes. Team members, such as intensivists, staff nurses, respiratory therapists and supportive staff (aids, techs, pharmacy, et cetera) work together in order to carry out all aspects of the bundle. The VAP bundle is initiated as a protocol for all mechanically ventilated patients within 24 hours of ventilation at these referred to facilities. The bundle calls for a strict set of actions to be taken to avoid the occurrence of the development of VAP. Some of these actions include: "keeping the head of bed elevated greater than 30 degrees, 12% chlorhexidine mouth wash/oral care, stress ulcer prevention, early weaning, gut decontamination and hand hygiene" (Juneja, 2011). Evidence supports the initiation of this protocol to help prevent death and deterioration of current critically ill patients. The problem arises when this protocol is not put into place immediately and the patients suffer a hospital acquired pneumonia on top of their admitting diagnosis. This proposal to resolve the issue will include initiating the VAP bundle protocol, to all mechanically ventilated patients in the Intensive Care Unit (ICU) setting within 24 hours of ventilation. Evidence supports a positive outcome in all instances where the VAP bundle protocol was implemented in a timely manner and compliance from staff was given.

Download or read book Significance of Ventilator Prevention Bundle to Achieve Better Results as Compared to Pharmacologic Agents written by Litty John and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The role that ventilator Associated Bundles plays in intensive care unit reveals a strategic milestone of nursing practice as opposed to the traditional measures of pharmacologic agents. The measures of Ventilator Associated Bundles have continued to be applied in the nursing care with the underlying challenge bordering on effective communication as well as sedation. This evidence based proposal attempt to draw a comparative value around the care bundle suitability of ventilation prevention bundles in addressing the ventilator associated pneumonia among critically ill patients. The CDC established specific guidelines to decrease the occurrence of VAP. The findings of the evidence based report touch on the need to utilize the four components of ventilators bundle including the elevation the patients head off the bed to about 40 degrees Celsius, allowing the sedation vacation done daily and followed with the routine assessments of the patients' readiness to exudate. In so doing, it emerges that, methods of DVT prophylaxis for prevention of deep venous thrombosis as well as peptic ulcers prophylaxis. Other methods that can be used to reduce the ventilator associated pneumonia includes oral hygiene and care, use of antiseptic rinse, use of specialized endotracheal tubes for purposes prevention of continuous aspirations, and use of closed in-line suctioning. Ventilator bundles provide an effective evidence based approach in modifying and expanding the use of specific processes of care among the critically ill patients. The proposal has demonstrated that the efficiency and significance around the use of ventilator prevention bundle posit a particular creation of bundle dimension to focus of ventilator associated pneumonia.

Download or read book Multidisciplinary Team Approach to Prevent Ventilator Associated Pneumonia written by Suzanne B. Breedlove and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator- associated pneumonia (VAP) exist as a major source of morbidity, mortality, and expense with an estimated economic impact of a sole instance of VAP reaching from $11,897 to $15,0841 in the intensive care unit (ICU), even with therapies directed against it (Garcia, et.al, 2009). It is the second most common hospital acquired infection in the United States according to Sedwick, Lance-Smith, Reeder, and Nardi, (2012), and is responsible for one fourth of the infections in the ICU despite the development of VAP bundles. The Center for Medicare and Medicaid Services (CMS) recently listed VAP as one of the reasonably preventable diseases, along with other hospital acquired infections (HAIs) and soon hospitals may lose reimbursement for the care provided to these patients. An article by Arroliga et. al, (2012) reports on a study involving a multidisciplinary team of practitioners; an intensivist (physician), registered nurse (RN), respiratory therapist (RT), and infection control practitioner, participating on a task force with an objective of reducing VAP. The research involved the respiratory therapist completing the mouth care portion of the ventilator associated pneumonia (VAP) bundle, instead of the nurse, with a dramatic improvement in their mouth care compliance. However, a stronger foundation was seen throughout the literature the multidisciplinary team. Defeating ventilator-associated pneumonia requires more than just bundle compliance; it is a complex disease requiring a multifaceted team. This proposed solution involves the implementation of a multidisciplinary team; including the co-management team (nurse unit manager and the physician champion), clinical educator, a statistician (quality and compliance representative) respiratory therapist, pharmacist, and project co-coordinator. This team will be entrusted with the responsibility to evaluate current practices and coordinate new ones. The findings of this study not only reflects on improving patient outcomes related to oral care compliance on ventilator A MULTIDISCIPLINARY TEAM 3 associated pneumonia in an adult intensive care unit but the role of the multidisciplinary team; where nurses, respiratory therapists, physicians, and administrators come together, in a novel way to attack problems that are unsolvable by only one department. Then again, if the ideas and efforts of several departments, all of which are focused on the same problem, are synthesized, a synergistic effect can be achieved, and selected goals are more likely to be accomplished (Kaye et.al, 2000)). Key to this multidisciplinary team approach is clear access to hospital management and a culture change where everyone becomes a key stakeholder in the process.

Download or read book Bundle Cares in Prevention of Ventilator associated Pneumonia written by LaWana Karn and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: One of the most commonly diagnosed and preventable hospital-acquired infections (HAIs) is ventilator-associated pneumonia (VAP). In the intensive care unit this infection affects 10-20% of all mechanically ventilated patients (Fakih, Heavens, Ratcliffe, and Hendrich, 2013). To prevent and reduce the prevalence of VAP, nurses and the health care team must work collaboratively and efficiently. To attain the goal of decreasing VAP infection rates, the bundle for ventilator care was developed. The Institute of Health Care Improvement (IHI) provided evidence-based guidelines for ventilator care bundles encompassed of head of bed elevation, a daily suspension in sedation for assessing favorable extubation, deep vein thrombosis and peptic ulcer disease precautions (Pinto and others, 2011). These measures of implementations establish a guide for ventilator protocols warranting improved VAP prevalence and ideal patient results. Increasing staff awareness through education prior to implementing any new or changes associated with bundle care protocols is necessary for optimal compliance and patient outcomes. To provide this knowledge to staff, educational in-services, tests, PowerPoint presentations, posters and informational pamphlets will be utilized for education. Follow-up feedback through and analysis of patient care, tests, and surveys will assist in ensuring comprehension, compliance and competence of staff, determining if sufficient education was provided along with any needed changes to the plan. Compliance interventions for bundle care such as checklist embodied within daily nursing documentation and performance completion is critical in achieving lower infection rates. This plan will encompass a proposal for implementing ventilator bundle care protocols with performance care of the mechanically ventilated patient in critical care, instituting compliance interventions and aspire educational means needed for decreased VAP incidents and increasing optimal patient outcomes.

Download or read book Importance of Staff Compliance with Bundle Care in Preventing Ventilator associated Pneumonia written by Joly S. Philip and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Several evidence-based research studies have conclusively confirmed in recent years that there has been a considerable increase in the incidence of ventilator-associated pneumonia (VAP) cases of mechanically ventilated patients in critical care units (CCUs). The statistical evidence suggests that VAP occurrence rate ranges from 30% to 50% among mechanically ventilated patients and this is one of the primary causes for increased morbidity and mortality in seriously ill patients. Usually VAP builds up after 48 hours of intubation in a mechanically vented patient. In the wake of the development of VAP patients are likely to have extended length of stay on mechanical ventilators and in the intensive care units (ICUs). The purpose of this study is to determine the effectiveness of comprehensive and multifaceted bundle care interventions with full staff compliance with the necessary protocols for preventing VAP in the ICU at Memorial Regional Hospital (MRH), Florida. The proposed intervention plan anticipates that with full observance of all the components of VAP bundle care, which comprises of: elevating the head of the bed (HOB) to 30--45°, sedation cessation for assessing the readiness to extubate, peptic ulcer disease and deep vein thrombosis prophylaxis if not contraindicated, use of chlorhexidine for oral care, humidification of inspired gas appropriately, suction of respiratory secretions whenever required, and due diligence in hand washing and other related safety measures as stipulated in proposed patient care protocols will all facilitate a significant reduction in the rate of VAP in mechanically ventilated patients in the ICU. In order to effectively prevent the incidence of VAP, and decrease the patient's length of stay, and healthcare costs, it is of considerably significant importance that appropriate and effective implementation of a multifaceted intervention that consists of methodologically developed tools and strategies in the facility, as elaborated in the proposal and as annexed in the Appendices, with a goal to increase the compliance of the staff with the VAP bundle. This project has been initiated by the author after conducting thorough critical appraisal of fifteen evidence-based research articles published in academic journals to examine and review the existing evidence about the test studies that confirmed the effectiveness and applicability of the VAP bundle in preventing incidence of VAP in mechanically ventilated patients. Subsequently the project has been taken up for further initiatives pertaining to the implementation by the Unit Practice Council (UPC). The interdisciplinary team participating in this project includes physicians, nurses, respiratory therapists, and clinical leaders. This proposal discusses in details about the issues associated with of VAP and then proposes a modified plan for the nursing and clinical interventions in the ICU. The project plan has also developed tools to increase staff compliance and knowledge with the components of VAP bundle care in order to prevent VAP rates in mechanically ventilated patients in the ICU. The UPC team established provisions and strategies to ensure the staff compliance on protocols of ventilator bundle care that has been proposed. The staff was provided with the education tools such as checklists, educational posters and power point presentation, daily goal sheets, and consistent feedbacks in order to achieve 100 percent adherence to VAP bundle care and thereby reduce the VAP incidence to zero. The study proved that with the compliance of the VAP bundle care, VAP rate has been considerably decreased in the ICU of Memorial Regional Hospital. It has been established that with the observance of VAP bundle care protocol for all mechanically ventilated patients, in collaboration with the members of an interdisciplinary team, a significantly cost effective and improved patient care outcome is expected achieve in the MRH.

Download or read book Ventilator Associated Pneumonia written by Catherine Egwu and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The continued incidence of ventilator- associated pneumonia (VAP) in patients in intensive care units has prompted organizations to seek processes to mitigate the many problems associated with VAP such as increased intensive care unit days, high cost of medical care, increased mortality and morbidity and reduced patient and family satisfaction. The institute for health care initiatives approved bundle practices for use in acute care facilities and sub-acute care facilities with ventilated patients. These bundle practices, when implemented, have proven to reduce the incidence of VAP. This capstone project, the author identified ventilator and associated pneumonia as a problem that needs close attention by health care professionals. A problem statement with support from literature is given. The implementation plan using the bundle practices and chlorhexidine oral solution is stated, and Kurt lLewin's theory is incorporated in the implementation exercise. Monitoring of compliance of staff to the bundle practices and evaluation of the effectiveness of the change in practice is done and evaluated. Education of staff in the new processes is imperative by using a dissemination process. Buy-in of all stakeholders is crucial in maintaining the desired process. Poor clinical outcomes are no longer acceptable in health care and time has come for organizations to put processes in place to mitigate VAP incidence.

Download or read book Prevention of Ventilator Associated Pneumonia in Patients on Mechanical Ventilators written by Monisola Jeyifous and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator Associated/Acquired Pneumonia (VAP) is a lung infection that appears 48 hours after a patient is on a ventilator. Pneumonia is one of the most prevalent infections that are acquired by critically ill patients while in the hospital. Pneumonia is a very serious condition in which a patient could pass away from. Nursing care has a high effect in controlling VAP. Nurses caring for patients on mechanical ventilators should be aware of the risk factors and include a plan of action in reducing these factors as part of nursing care. There are many things that can be done to prevent the patients from acquiring VAP or to treat them for VAP. Research has indicated that one of which is to utilize a VAP Care Bundle.

Download or read book EVIDENCE BASED GUIDELINES ON V written by Mei-Yan Yeung and published by Open Dissertation Press. This book was released on 2017-01-24 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Evidence-based Guidelines on Ventilator-associated Pneumonia Prevention for Mechanically Ventilated Patients" by Mei-yan, Yeung, 楊美恩, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. DOI: 10.5353/th_b4462688 Subjects: Respirators (Medical equipment) Pneumonia - Prevention Nosocomial infections - Prevention