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 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 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 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 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 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 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 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 Significance of Specialized Education on Nurses Compliance Rate with Oral Care Protocol for Mechanically Ventilated Patients in Adult Intensive Care Unit written by Marharyta Dulevich and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Varieties of documented studies suggest the oral care protocol for mechanically ventilated patients significantly decrease rate of ventilator-associated pneumonia in adult population. Nevertheless, practice reveals a lack of specialized education in regards of oral care protocol and as a result- unsatisfactory compliance rate among nurses involved in care of mechanically ventilated patients. Oral care instructions and follow-up actions have been proved its effectiveness and efficiency. Meanwhile, high oral care compliance rate is associated with better patients' outcomes, shorter intensive care unit stay and hospitalization, lower mortality rate, and financial benefit for a hospital. Implementing specialized education for critical care nurses with systematic follow-up actions can increase the compliance rate with all mentioned above positive outcomes. This project is focused on comprehensive literature review, clinical observation of current practices and policies, and proposal of improvement actions.
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 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 Ventilator Associated Pneumonia written by Leelamma John 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 a nosocomial hospital acquired infection found in patients who are mechanically ventilated. The infection usually happens forty-eight hours after endotracheal intubation or tracheostomy. VAP increases hospital stay by at least 7-9 days and increases hospital costs per patient by an average of $40,000. VAP increases morbidity and mortality rates in patients admitted in the intensive care units (ICU). Because it is a hospitalacquired infection, prevention is every hospitals' responsibility. The current VAP rate in hospitals is 9-27%. This shows the importance of change in current practice because the current percentage of VAP is unacceptably high. The results from various evidence-based research studies, has proven that VAP care bundles would change nursing practices. Educating the ICU clinical staff about the VAP care bundle is crucial to patient safety because it has shown positive results. The VAP care bundle includes head of the bed elevation, aspiration of secretions, daily sedation vacation, daily check-up for readiness for weaning off the ventilator, hand hygiene, and the use of chlorhexidine for oral hygiene. Each clinical staff should know the early signs of VAP. One of the research studies shows the nurses' role in preventing of VAP. "Each critical nurse can play a functional role in reducing and preventing the occurrence of VAP, subsequently improving the patients' recovery rate and consequently reducing health care costs," (Kwong, A., Chair, S., and Suen, L., 2009).
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 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 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 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.
