Download or read book Oral Care Education with VAP Bundle for Intubated ICU Patients written by Jennifer Herman and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patients in the Intensive Care Unit (ICU) intubated with mechanical ventilators had a higher incidence of pneumonia than other patients, resulting in a higher mortality rate. Ventilator Associated Pneumonia (VAP) rates demonstrated a significant increase after a patient has been intubated for more than two days. Research indicates that bacterial colonization is a major cause of pneumonia resulting in higher VAP rates. A survey of multiple studies has indicated that a VAP care bundle that includes oral care for the patient can reduce the VAP rate to near zero. The VAP care bundle is composed of elevating the patient's head, brushing the patients' teeth with sterile water, and suctioning the fluid from various collection points to remove the potential bacterial colonization. Additional research indicates nursing staff are effective in implementing procedures learned during their initial training, or will readily adopt a new procedure when the training includes the evidence to support the expected results of the procedure. The implantation of this solution includes initial training of the staff, in addition to educational posters posted in critical locations. A committee designated to track the implementation of the program will adjust the implementation plan based on ongoing metrics collected. At the end of the implementation period, the committee will prepare a report detailing the results of the VAP care bundle for distribution in the facility of the implementation. In addition, the committee will oversee the development of a white paper detailing the project and the results for dissemination across the health care industry, particularly to similar ICU facilities.
Download or read book Prevention of Ventilator associated Pneumonia written by Robyn Prather 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 defined as a Hospital Acquired Infection (HAI) that develops in patients who have been ventilated for more than 48 hours and who were not diagnosed with a pneumonia when intubated. VAP is associated with increased mortality, morbidity, lengths of stay, and increased cost of care. It is the leading cause of death of all hospital acquired infections carrying a mortality rate of 46%. VAP also plays a role in 30% of additional deaths of these critically ill patients due to hospital system failures that could have been avoided. Studies have shown that by implementing evidence based best practices called the VAP bundle on all ventilated patients the incidence of VAP may be decreased up to 45% (safer healthcare now, 2012). While oral care is a component of the VAP bundle, more study is needed regarding best practices for this care component. Current research indicates that a high level of compliance to a scheduled oral care regiment using an antimicrobial solution of 0.12% Chlorhexidine results in the greatest reduction in oral bio-burden (Bopp, Darby, Loftin, and Broscious, 2006). The objective of this study is to test this intervention in reducing bacterial load in the oral cavity and to support the intervention through increased staff compliance to the proposed oral care regimen. Data will be gathered and analyzed to better identify causative factors to VAP, and to monitor compliance to the proposed oral care protocol. The target group for intervention will be all adult patients admitted to the Intensive Care Unit (ICU). The target group for compliance will be all clinical staff in the ICU. The project will take place over a one year period and will include education, training, the oral care protocol, data collection, and reporting results to both clinicians and stakeholders. Expected results are increased staff compliance greater than 90% and a reduction in VAP of 50% at the end of the study.
Download or read book Implementation of an Oral Care Protocol to Decrease Incidence of Ventilator associated Pneumonia written by Brittanie Cordova and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on documented studies, ventilator-associated pneumonia (VAP) is a leading nosocomial infection in critical care settings. In a critically ill patient, the development of VAP significantly increases their risk of mortality, length of hospital stay, and decelerates the speed of recovery. Research has shown a substantial correlation between poor oral hygiene in mechanically ventilated (MV) patients and the development of VAP. The implementation of an oral hygiene protocol and/or order-set increases nurse adherence to performing these interventions, improves quality of oral care practices, and ultimately reduces the incidence of VAP. The successful implementation of an oral care protocol requires thorough preparation. Components of implantation will include gathering of evidence, literature review, stakeholder presentation, involvement and education of intended staff, actual implementation, evaluation plan, and dissemination of evidence. The effective implementation of an oral care protocol in intensive care units for MV patients will decrease the incidence of VAP, reduce hospital stays, and decrease costs.
Download or read book Comfort Theory and Practice written by Katharine Kolcaba and published by Springer Publishing Company. This book was released on 2003 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: I am most excited and impressed with the scope and focus of this work. As I began to read it, I had trouble putting it down. It is highly readable, engaging, all-inclusive, and most informative. Jean Watson, RN, PhD, HNC, FAAN I am honored and delighted to recommend this text for all nurses who cared for and care about patients. from the Foreword by May Wykle, RN, PhD, FAAN This book places comfort at the forefront of nursing care, by presenting a carefully researched theory of comfort that nurses can use as a framework for practice. Engagingly written, the book combines a first-person account of the development of the theory with supporting research, and practical information for its application. Kolcaba analyzes the concept of comfort; describes its physical, psychospiritual, environmental and sociocultural components; evaluates its meaning in the many different contexts in which health care occurs; and describes how it can be measured. The appendix includes comfort care questionnaires that can be used with patients in many settings, and a comfort scale that can be used with patients for a quick assessment of comfort. Clinicians, researchers, educators, and students will find this holistic approach helpful in setting priorities and parameters for patient care.
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 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 Continuing Education for Ventilator Associated Pneumonia written by Michelle Barb and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: From the moment nursing school is started, nurses are taught the importance of infection control and ways to prevent certain infections from occurring within the hospital setting. For many this knowledge becomes the cornerstone for prevention in the career practice. While others allow short cuts in their practice in order to obtain better time management and prioritize other practices, exposing patients to potential ancillary infectious processes. This form of practice can lead to detrimental patient outcomes. In the ICU, patients receiving mechanical ventilation are at increased risk of developing ancillary disease processes such as VAP. The incidence of VAP was reported to range 9-27% with a mortality rate that may exceed 50% for those receiving mechanical ventilation (Hoshijima and others, 2013, pages 349). One of the main causes of VAP is poor oral hygiene care with the most up to date evidence based practices. While nurses manage their time throughout the day, many will take short cuts and pass on something simple such as oral hygiene in order to have time for other responsibilities. This thought process can prove costly to the hospital in the mechanically ventilated patient population. In order to combat this thought process and provide proper oral hygiene, nurses need to value the cost of this disease process and the financial burden it takes on the hospital. By giving the nurse the information about VAP, the mortality rates and the costs related to it, they can in turn provide better oral hygiene with the latest evidence-based practices when tending to a mechanically ventilated patient.
Download or read book Annual Update in Intensive Care and Emergency Medicine 2011 written by Jean-Louis Vincent and published by Springer Science & Business Media. This book was released on 2011-04-02 with total page 830 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Annual Update compiles the most recent developments in experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.
Download or read book Ventilator Associated Pneumonia Bundled Care Prevention Strategies for ICU Patients written by Linda Crump and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The education of health care staff is required in order to prevent the occurrence of ventilator associated pneumonia (VAP) through the consistent use of ventilator-associated pneumonia bundled care. VAP bundled care strategies are based on evidence based research data that has been shown to decrease the incidence of VAP infections when all of the protocol steps are followed consistently, however, the continued incidence of VAP infections necessitates the education/re-education of health care personnel caring for patients on ventilators on the use of VAP bundled protocols in order to reduce to zero the incidence of VAP infections. VAP infections account for 90% of hospital acquired infections (HAI), are the second most common HAI, and typically occurs 48 hours or longer after endotracheal intubation. VAP infections can increase the patient09́s length of time on the ventilator, increase their hospital stay, exacerbate their current and co-morbid health issues, is associated with increased mortality rates, and can drastically increase health care costs. Health care workers that are well educated and consistently use VAP bundled care protocols will succeed in decreasing the incidence of VAP infections, will promote better patient outcomes, and produce marked savings inhealth carehcare costs; those that do not consistently use these protocols will contribute to the increased incidence of VAP infections and possibly increase the mortality risk for the patient. This literature will present the educational process that will promote the implementation and consistent, compliant use of evidence based VAP bundled care protocols that will reduce and prevent the incidence of VAP infections in our ICU vented patients as we strive to improve and promote better patient outcomes.
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.
Download or read book The Relationship of Oral Care Routines and Ventilator Associated Pneumonia in Mechanically Ventilated Pediatric Critical Care Patients written by Ambre' L. Huff and published by . This book was released on 2007 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: Key Words. oral care, mechanically ventilated, ventilator associated pneumonia.
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 Ventilator associated Pneumonia Prevention Bundle written by Mardin Sabir 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 devastating preventable diagnosis that causes increase in mortality, morbidity and cost in intensive care unit for patients that are intubated and mechanically ventilated. "Ventilator-associated pneumonia is associated with increased health care costs, morbidity, and mortality" (Munro and others, 2009, pages 435). Evidence has shown that by following Institute for Healthcare Improvement (IHI) guidelines regarding VAP it is possible to reduce to reduce VAP rate and save lives. Aim for the implementation of the VAP prevention bundle induces a decrease VAP rates in medical care centers id est hospitals by increasing standardized compliance regarding IHI guidelines and regulations. Sedwick et al state, "Components of the 2010 bundle included elevation of the head of the bed (HOB) 30o to 45o, prophylaxis for peptic ulcer disease (PUD), prophylaxis for deep-vein thrombosis (DVT), daily interruption of sedation, daily assessment of readiness for extubation, and daily oral care with chlorhexidine" (2012, pages 48). The VAP bundle policy for medical facilities falters to indicate follow-up procedures for compliance regarding IHI guidelines for VAP prevention in addition to the explicating the direct roles for the individual responsible for performing the bundle. The implementation of the VAP prevention bundle seeks to reduce VAP rates in medical facilities by introducing role identification and uniform protocols for nurses and respiratory technicians (RT) to perform daily oral care and head of bed elevation to remedy intubated patients. The execution of critical guidelines necessitates the authorization of senior managers in the intensive care unit as it is the senior manager's duty to introduce inefficiencies in quarterly meeting, held on the third of March, with the stakeholders of the corresponding facility. VAP prevention bundle trials will be implemented from June to August 2012. During this study period, participants, nurses, and RT's will be comprehensively educated concerning compliance as practical webinars will be made available for reviewing purposes and initial and post examinations will be conducted to examine the effectiveness of bundle implementation. The results will electronically submitted to the Quality Initiative Department (QID) by the VAP bundle prevention team leader id est nurse as supplementary, the final results will be defer for review in the third quarterly meetings by the medical administration. Following, a copy of evidence-based trial results for VAP prevention implementation data will be sent to IHI and International Nosocomial Infection Control Consortium (INICC). Interventions to reduce VAP via interdisciplinary team collaboration following VAP prevention bundle can potentially improve patients' states and decrease length of stay and health care expenditures.
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 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 Implementing Measures to Decreasing Ventilator Associated Pneumonia written by Shane R. Fernando and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Ventilator Associated Pneumonia (VAP) has been on the rise in a large trauma hospital in Arizona. Objective: Utilizing a multidisciplinary team approach to implement measures to improve the current care practices for nurses and respiratory therapist caring for mechanically ventilated patients in the Intensive Care Unit (ICU). Method: Improving the currently used ventilator care bundle to include; oral decontamination using Chlorhexidine Gluconate (CHG) every 12 hours, tooth brushing every 4 hours and the concurrent use of the accompanying oral care protocol which includes the use of an Oral Assessment Guide (OAG) and over the cuff/deep suctioning. Results: Initially the nurses and the respiratory therapist were not 100% compliant. However, through education using Evidence-Based Practice and incentives, compliance increased. The increase in compliance also decreased the incidence of VAP in the ICU. Conclusion: By utilizing a multidisciplinary team approach, education, documentation and EBP, the incidence of VAP was significantly reduced in a large trauma hospital in Arizona.
Download or read book ICU Care of Abdominal Organ Transplant Patients written by Ali Al-Khafaji and published by Oxford University Press. This book was released on 2013-02-12 with total page 293 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pre- and post-operative care of transplant patients is an aspect of Critical Care Medicine in which most ICU physicians and nurses have received little or no formal training and are left to cope with this complex population with only incomplete "on the job experience" as a guide. In response to this clinical knowledge gap, ICU Care of Abdominal Organ Transplant Patients provides a concise at the bedside resource fo intensivists, surgeons, and nurses caring for abdominal organ transplant patients before and after surgery. In a concise, practical style, the authors offer concrete solutions to questions and situations confronted by ICU clinicians. Chapters address general principles of immunosuppression, infectious complications, management, and nursing considerations plus indications, approach to anesthesia, transplant procedure, and post-operative course for liver, kidney, pancreas, islet cell, and small bowel and multivsceral transplantation.
