Download or read book Impact of Oral Care on the Prevention of VAP written by Ashley Mize 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) proves to be a problem among patient's in the Intensive Care Unit (ICU). The incidence of VAP demonstrates a direct relationship with negative patient outcomes, such as; increased morbidity and mortality, increased length of stay in hospital, and increase financial burden for health care facility. In utilizing evidence based practice, it has been proven that healthcare workers can assist in the reduction of these negative outcomes. A simple and low cost intervention such as proper oral care within a ventilator bundle has been proven effective in the attempt to decrease the incidence of VAP. The purpose of this paper is to propose the use of standard oral care within the ventilator bundle as a resolution to the increased incidence of VAP. The proposal will first describe VAP as essentially being the problem at hand. It will then propose a resolution to the problem. An implementation plan will be discussed giving detail about who the stakeholders will be and how and when the proposed change will take place. Evaluation of the plan is the next step and an essential part to the proposal. This will evaluate whether the proposal is effective. Once effectiveness has been determined the evidence must be disseminated. A discussion will take place on tools and processes used in the process of presenting the information to the stakeholders. It is essential to have all parts of the proposal discussed above in order to obtain positive outcomes from the plan. Obtaining the approval and compliance of a multidisciplinary team is essential to successful implementation of a new policy or procedure.
Download or read book Effect of Oral Care for the Prevention of Ventilator Associated Pneumonia written by Minni Kannampuzha 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 and its detrimental effects on patient, family and health care settings are a big concern for the current healthcare system. Ventilator associated pneumonia (VAP) is one of the most common hospital acquired infections among patients in the ICU, with an estimated incidence of 10 and– 20% in some institutions (CDC, 2012). VAP continues to be substantially associated with patient morbidity and mortality and also increases utilization of healthcare resources, longer hospital stays and higher health care costs (Sandrock and Daly, 2012). Numerous studies demonstrated a significant reduction of incidences of VAP following the introduction of a practice change in oral care (Cutler and Sluman, 2014). This paper will discuss methods of developing the use of ventilator care bundle with oral care, the importance of multidisciplinary approach like involving respiratory therapists to provide oral care to improve the compliance of oral care in mechanically ventilated intensive care unit patients (ICU), implementation of change as well as outcome of ventilator care bundles with oral care for the prevention of VAP in mechanically ventilated ICU patients. VAP has great significance to nursing because nursing staff are able to implement interventions that can prevent infection, thereby relieving the financial burdens on patients and organizations.
Download or read book Professional Research Project written by Julie George 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 is a serious hospital-acquired infection with reported incidence rate of 12.2% and mortality rate of 29.3%(Chao and others, 2009).Strict implementation of oral care protocol can prevent VAP to greater extent. With the help of 15 evidence-based articles on prevention of VAP, the writer implemented a comprehensive oral care protocol in critical care unit of white memorial medical center where 80% of the patients were on mechanical ventilator. Regardless of whether the experiences and skills of the hospital's staff are known or not, oral care practices within the hospital were practiced. As an emphasis on the relevance and significance of this study, the implementation of oral care to counter VAP was aimed to fight back stress to both the patient and his/her family, reduction of the duration a patient takes under ventilation, and elimination of cumulative costs associated with the prolonged admissions. The author was able to complete the project on VAP with the support from the resource personnel, such as the infection control, research nurses, and pharmacists, physicians, and staff members of the MICU. Various tools like power point presentations were used to educate the nursing staff about the significance of oral care. To determine the efficiency of the proposed solution implemented, the members used evaluation tools in the form of patient chart auditing and feedback from the nurses. The findings of the study are assessed by the nursing research committee and quality control department and necessary changes being made in the existing policy. A new protocol for the oral hygiene was also implemented in ICU.
Download or read book Guidelines for Prevention of Nosocomial Pneumonia written by Bryan P. Simmons and published by . This book was released on 1982 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Antiseptic Stewardship written by Günter Kampf and published by Springer. This book was released on 2018-08-25 with total page 722 pages. Available in PDF, EPUB and Kindle. Book excerpt: Various antiseptic agents, such as chlorhexidine, are used for different applications, e.g. in healthcare, veterinary medicine, animal production and household products, including cosmetics. However, not all antiseptic agents provide significant health benefits, especially in some products used in human medicine (alcohol-based hand rubs, antimicrobial soaps). While some products (antimicrobial soaps, surface disinfectants, instrument disinfectants, wound antiseptics) may contain one or more biocidal agents with a comparable antimicrobial efficacy but large differences in their potential for microbial adaptation and tolerance. An increased bacterial resistance has been described for various antimicrobial agents, sometimes including a cross-resistance to antibiotics. The book is the first comprehensive reference resource on antiseptic agents, including their efficacy, natural and acquired resistance, adaptation, and cross-resistance. It also discusses their and appropriate use in terms of a balance between their efficacy and the risk of acquired bacterial resistance / tolerance. Focusing on human and veterinary medicine and household products, it helps readers make informed decisions concerning against antiseptic products based on their composition. The book contributes to reduce any unnecessary selection pressure towards emerging pathogens and to keep the powerful antiseptic agents for all those applications that have a clear benefit (e.g. reduction of healthcare-associated infection).
Download or read book Comprehensive Oral Care to Prevent Ventilator Associated Pneumonia written by Mejo Vayalil and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Effective oral care is an important part of nursing care in mechanically ventilated patients in the Intensive Care Unit (ICU) (Shi and others, 2013). According to studies, Ventilator Associated Pneumonia (VAP) is one of the leading causes of death in ICUs and it occurs in 9% to 28% of patients treated with mechanical ventilation, and the percentage of mortality rates of this problem are from 24% to 50%' (Berry and others, 2007). There are many studies done to find out about the onset of VAP in mechanically ventilated patients. According to one of the studies, 'Ventilator-associated pneumonia (VAP) occurs within 24 hours of intubation and mechanical ventilation' (Stonecypher, 2010). Due to the assistive-breathing devices and the medications used to keep the mechanically ventilated patients sedated, normal defense mechanisms change, and they become more vulnerable to respiratory infection such as VAP (Pear, 2007). By implementing evidence based oral care into clinical practice, staff members can reduce the cases of VAP and also can improve the quality of care in ICUs. The purpose of this proposal is to implement a comprehensive oral care protocol in critically ill patients such as mechanically ventilated patients in ICU to reduce or prevent the incidences of VAP. Through this proposal the author will also talk about the consequences of inadequate oral care in ventilated patients. The nursing theory, which supports the writer's proposal, is Florence Nightingales environmental theory. A healthy environment is essential for the faster and better healing and recovery according to the Nightingale theory. Evidence based practices and 15 articles containing information about the importance of comprehensive oral care will also supports the author's proposal of reducing or preventing the cases of VAP in ICUs.
Download or read book Case Studies in Adult Intensive Care Medicine written by Daniele Bryden and published by Cambridge University Press. This book was released on 2017-04-20 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This case-based approach to the intensive care medicine curriculum provides 48 case studies linking core knowledge to clinical context. Topics chosen have been mapped to eight key areas of study, making this ideal for both FFICM and EDIC exam candidates.
Download or read book Oral Health and Ventilator Associated Pneumonia in Older ICU Patients written by Gina Maria Luciano (ACNP-BC) and published by . This book was released on 2014 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator-associated pneumonia (VAP) is the leading cause of morbidity and mortality in the ICU, particularly in older patients. Strategies to reduce or prevent the incidence of VAP are crucial. One of the less understood risk factors for VAP is poor oral health. This study provided the first evaluation of preoperative oral health status as a risk factor for ventilator-associated pneumonia in older adults. While oral health, dental plaque and oral bacteria have been suggested in the literature as linked to VAP, the association between amount of plaque before and after surgery and VAP risk has not previously been directly studied. The model used to guide this study is based on the Human Response Model (HRM) of Heitkemper and Shaver. A prospective, correlational design was used to measure the relationship between oral health and VAP. A convenience sample of 96 adults over 50 years old were recruited from patients scheduled for elective cardiac, abdominal, thoracic or vascular surgery, who required oral intubation and mechanical ventilation post-surgery. Oral health was evaluated by dental plaque accumulation using the University of Mississippi Oral Hygiene Index (UM-OHI). VAP was diagnosed using the Clinical Pulmonary Infection Score (CPIS) within 24 hours of intubation and up until postoperative day seven. Multiple and logistic regression analysis indicated that preoperative oral health significantly predicted postoperative oral health and accounted for 64% of the variability in postoperative oral health. Overall, oral health declined from preoperative to postoperative but deteriorated less in cardiac surgery patients. Higher patient acuity, greater number of comorbidities and being female was associated with an increased likelihood of developing ventilator-associated pneumonia. Although this study did show a decline in oral health from preoperative to postoperative, it did not find a direct relationship between the quantity of dental plaque and VAP. This study did find that VAP risk is likely related to preoperative comorbidities and vulnerabilities, and to hospital acuity and course. A VAP reduction strategy which focuses on plaque quantity reduction as its target may not be effective. This study can serve as a basis for future studies investigating the impact of oral health on ventilator-associated pneumonia.
Download or read book Professional Research Project written by Sonia Shinu 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 one of the common hospital acquired infection in critically ill mechanically ventilated patients. It is often associated with high mortality rates, morbidity rates, prolonged hospital stays and increased healthcare costs (Augustyn, 2007). Even though VAP has a large impact on the mortality and morbidity, it is often preventable. VAP has many risk factors and many nursing interventions are effective in reducing the incidence of this condition. Research evidence supports the use of chlorhexidine (CHG) mouthwash in the prevention of VAP. Zhang et. al (2014) reported that CHG use is effective in preventing VAP, one of the nosocomial infections. In another study, Munro et. al (2009) also reported that CHG is effective in preventing VAP. The article,' Effect of oral care on bacterial colonization and ventilator associated pneumonia' (Halm and Armola, 2009) also provides satisfactory information on the prevention of VAP by using CHG. As per the article, 'Oral hygiene with CHG in preventing pneumonia associated with mechanical ventilation' (Beraldo and Andrade, 2008), CHG helps to diminish colonization and thus help in decreasing the incidence of VAP. This project incorporates Kurt Lewin's Change theory to the proposed plan to reduce VAP by using CHG oral rinse. This proposal will include an implementation plan as well as an evaluation as a part of the research process. The proposed plan and outcomes of the project will be disseminated to the stake holders namely the Chief Nursing Officer, Chief of Pulmonology services, Director of Respiratory Services, Director of Nursing, Director of Pharmacy, Case Managers, Clinical Educators, Nurse Managers and the nursing staff members. There is a power point presentation included in the project as an educational tool for the participants and stakeholders. The evaluation tool for the participants is a posttest which can be used to assess the knowledge of the nursing staffs about the project after giving necessary education materials. The evaluation tool consists of a quarterly audit charts which can give clear evidence about the success of the implemented plan. The outcomes of the project will be properly analyzed, evaluated and will be presented to the stakeholders and the nursing staff.
Download or read book The Impact of Specialized Nurses Education on Oral Care to Patient on Mechanically Ventilation in Adult Intensive Care Unit written by Joyce Dabiri and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study is a comprehensive literature review and clinical observation of current practices and policies and the proposed method of different oral hygiene in reducing the incidence of ventilation- associated Pneumonia. This condition (VAP) is a huge concern in the intensive care units as a result of infection which occur few days after intubation with endotracheal tube. It can be very challenging taking care of these type of patients due to the multifaceted health issues, particularly if their respiratory system is already compromised. Oral hygiene is considered to be an important intervention, in combination with other strategies, for the prevention of ventilator-associated pneumonia. Data suggest that the simple reduction of risk through better oral hygiene can lead to fewer incidence of Ventilator-Association Pneumonia. In addition to brushing, providing oral moisturizer to oral mucosa and lips every 2 to 4 hours is often a component of the oral care protocol. Implementation of an oral care protocol, ongoing nurse education, and evaluation were important in reducing the incidence of VAP. The use of teamwork tools and strategies to ensure this consistency can have a tremendous impact on closing the gap, improving patient outcomes, shorter length of stay in the intensive Care Unit and reduction of health care cost.
Download or read book Oral Care Intervention to Prevent Ventilator Associated Pneumonia written by Bincy Kappen 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) is a common complication and linked to high mortality and morbidity among mechanically ventilated patients in the United States (Zurmehly, 2013). It is the second most common hospital-acquired infection that carries a 40% - 80% mortality rate (Fields, 2008). The Southwest Medical Center (SMC) is a 406-bed hospital located in Oklahoma City, Oklahoma. The VAP rate for the last six months during the year 2008 was reported as 4.3, 4.7, 0.0, 4.1, 3.9, and 0.0 respectively (Oklahoma Hospital Report, 2009). Each episode of VAP incidence can cost an average $40,000 more in healthcare expenses (Zurmehly, 2013). The proposed intervention for oral hygiene in intubated ventilated adult patients is tooth brushing three times a day and 0.12% chlorhexidine application twice a day. This mechanical and pharmacological intervention is to promote oral hygiene and thereby reduce the colonization of oropharynx and dental plaque by bacteria (Feider, Mitchell, and Bridges, 2010). The variables measured here are ventilator-associated pneumonia (VAP) rates, ventilator days, length of stay of patients in intensive care unit (ICU), length of stay of patients in hospital, frequency of tooth brushing, frequency of chlorhexidine application, oral care evaluation score, acute physiology and chronic health evaluation score, mortality rates of ventilated patients, and patient demographics. The infection-control department will keep track of the data collected during intervention and pre-intervention period. Unit directors and infection-control department will work together to evaluate the implementation process. Different strategies were used to disseminate the evidence within the organization and to the outside healthcare community.
Download or read book Surgical Intensive Care Medicine written by John M. O'Donnell and published by Springer Science & Business Media. This book was released on 2009-11-18 with total page 711 pages. Available in PDF, EPUB and Kindle. Book excerpt: We are honored to present the second edition of Surgical Intensive Care Medicine. Our first edition was considered to be an important contribution to the critical care literature and received excellent reviews from Critical Care Medicine, Chest, and Anesthesiology. In the second edition, the basic organization of the book remains unchanged, being composed of 60 carefully selected chapters divided into 11 sections. The book begins with general topics in primary intensive care, such as airway management and vascular cannulation, followed by categories based on medical and surgical subspecialties. While the chapters discuss definitions, pathophysiology, clinical course, complications, and prognosis, the primary emphasis is devoted to patient management. The contents of the current edition have been comprehensively upgraded and the chapters retained from the first edition have been thoroughly updated, revised, or rewritten. In this second edition, some new topics have been added including Postoperative Care of the Obese Patient, Postoperative Care of the Pancreas Transplant Patient, Optimization of High-Risk Surgical Patients, Post- erative Alcohol Withdrawal Syndrome, Ethics and End of Life Issues, Improving the ICU, and Continuous Medical Education in Intensive Care Medicine. We are extremely fortunate to have high-quality contributors, many of whom are nationally and internationally recognized researchers, speakers, and practitioners in Cri- cal Care Medicine. An important feature of this latest edition is the geographical diversity of its authors. Most are based in the United States, but colleagues from Canada, England, Ireland, Germany, Belgium, Holland, France, Italy, Portugal, and Australia have also made notable contributions.
Download or read book Oral Biofilms written by S. Eick and published by Karger Medical and Scientific Publishers. This book was released on 2020-12-21 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: Biofilms are highly organized polymicrobial communities that are embedded in an extracellular matrix and formed on natural and artificial surfaces. In the oral cavity, biofilms are formed not only on natural teeth, but also on restorative materials, prosthetic constructions, and dental implants. Oral diseases like caries, gingivitis, periodontitis, and also pulp inflammation are associated with biofilms. This publication is an up-to-date overview on oral biofilms from different clinically relevant perspectives. Experts comprising basic researchers and clinicians report on recent research relating to biofilms - from general summaries to recommendations for daily clinical work. This book covers all aspects of oral biofilms, including models used in the laboratory, biofilms in dental water unit lines, periodontal and peri-implant biofilms, caries-related biofilms, halitosis, endodontic biofilms, and Candida infections, as well as biofilms on dental materials and on orthodontic appliances. Several chapters deal with anti-biofilm therapy, from the efficacy of mechanical methods and the use of antimicrobials, to alternative concepts. This publication is particularly recommended to dental medicine students, practitioners, other oral healthcare professionals, and scientists with an interest in translational research on biofilms.
Download or read book Dental Caries written by Ole Fejerskov and published by John Wiley & Sons. This book was released on 2009-03-16 with total page 641 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of Dental Caries: the Disease and its Clinical Management builds on the success of the prestigious first edition to present an unrivaled resource on cariology. The clinical thrust of the first edition is widened and strengthened to include coverage of the disease in all its variety, from eruption of the first primary tooth to the prevalent forms of the disease in older patients. The centrality of caries control and management to the dental health of all populations is further emphasized, as the book goes beyond the successful treatment of carious lesions to demonstrate the long-term consequences of the non-operative and therapeutic techniques employed.
Download or read book Selective Decontamination of the Digestive Tract SDD written by Hans Rommes and published by Springer Nature. This book was released on 2021-03-08 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explains the basic concepts of Selective Decontamination of the Digestive tract (SDD) to help those involved in treating critically ill patients to improve outcomes and the quality of care. SDD has led to major changes in our understanding, the treatment and prevention of infections in critically ill patients over the past 40 years. It is the most studied intervention in intensive care medicine and is the subject of 73 randomized controlled trials, including over 15000 patients and 15 meta-analyses. SDD reduces morbidity and mortality, is cost-effective and safe as SDD does not increase antimicrobial resistance. Correct application of the SDD strategy enables ICU teams to control infections – even in ICUs with endemic antibiotic resistant microorganisms such as methicillin resistant S. aureus (MRSA). Describing the concept and application of SDD, and presenting case studies and microbiological flow charts, this practical guide will appeal to intensivists, critical care practitioners, junior doctors, microbiologists and ICU-nurses as well as infection control specialists and pharmacists.
Download or read book Prevention of VAP written by Seba Korula and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator Associated Pneumonia is a common cause of infection associated with patients who are orally intubated and on mechanical ventilator. VAP is a health care-associated infection consistent with the presence of an endotracheal tube and mechanical ventilation for greater than 48 hrs. Research studies done to find the effectiveness of chlorhexidine verses the use of normal saline for the oral care in preventing the VAP. Implementation of the established protocols for the oral care using chlorhexidine is effective in preventing VAP. The research project outcome is found to be more effective in preventing complications associated with mechanical ventilation and reduces the complications, length of stay and the cost of health care in an acute care setting.
Download or read book AACN Procedure Manual for Critical Care written by Debra J. Lynn-McHale Wiegand and published by Saunders. This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This sixth edition presents procedures for the critical care environment in an illustrated, step-by-step format. The Procedures and Patient Monitoring sections are presented in a tabular format that includes special considerations and rationales for each intervention.
