Ventilator associated pneumonia - Essay Example

This element decreases VAP by decreasing the risk of aspiration of gastrointestinal secretions and also oro-naso-pharyngeal secretions and also by improving ventilation of the patient through higher spontaneous tidal volumes when compared to supine position (Safer Healthcare Now, 2011). Hospitals in Canada can implement this component by implementation of a strategy that ensures head end elevation like documentation of the intervention in nursing flow charts at regular intervals, as a topic of discussion during multidisciplinary daily rounds and as documentation on goals sheet.

A protractor must be brought into the ICU to demonstrate the nursing staff as to how 45 degrees elevation looks like. A piece of colored tape must be pasted on the wall behind the bed of the patient to ensure compliance during ventilator checks. Another implementation strategy would be to include a specification for monitoring of head of the bed by mechanical devices. An environment must be created where all health professionals like orderlies and radiology technicians are encouraged to notify the nursing as to whether the head of the bed is elevated. . The staff must be encouraged and motivated for compliance (Safer Healthcare Now, 2011). 2. Daily performance of readiness to extubate by interruption of sedation and spontaneous breathing trial This is done to decrease the duration of mechanical ventilation and also early extubation which decreases VAP.

This also decreases exposure to ventilator-circuit endotracheal tube device (Safer Healthcare Now, 2011). This element can be implemented by introducing a process which temporarily interrupts sedation every day at an appropriate time, like before rounds, to reappraise the neurocognitive ability of the patient, to assume a breathing pattern that is viable and to ascertain needs for analgesia and sedation. Sedation scale must be used to prevent under-sedation. These must be standardized for all mechanically ventilated patients and both these strategies must be linked into the protocol of weaning process.

Non-invasive ventilation can be used as a strategy to liberate patients from mechanical ventilation. Compliance must be discussed every day during rounds and compliance must be used to motivate and encourage the staff (Safer Healthcare Now, 2011). 3. Use of oral tubes rather than nasal tubes for tracheal or stomach access. This reduces the risk of nosocomial sinusitis and thus decreases the risk of VAP (Safer Healthcare Now, 2011). This element can be incorporated in the hospitals by making orotracheal intubation the standard protocol for mechanical ventilation.

In all patients receiving mechanical ventilation for more than 24 hours, orogastric tube must be placed for gastric decompression and feeding rather than nasogastric tube and this must also be included in the protocols in not only ICUs, but