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Ventilator Associated Pneumonia - Proposed Solution, Implementation and Evaluation - Essay Example

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Proposed Solution, Implementation and Evaluation XXXXX Grand Canyon University HLT 490V Capstone Project Date Proposed Solution, Implementation and Evaluation In this paper, the solution, implementation and evaluation of the use of ventilator care bundle to reduce the risk of ventilator associated pneumonia will be presented…
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Ventilator Associated Pneumonia - Proposed Solution, Implementation and Evaluation
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Download file to see previous pages VAP is associated with increase in morbidity and mortality, hospital length of stay and costs. It has been found that the mortality rate as a result of VAP is 27% and has been as high as 43% when the contributing agent was antibiotic resistant. When a patient is diagnosed with VAP, the length of his stay in the Intensive Care Unit (ICU) is increased by 5-7 days and the duration of hospital stay is increased by 2-to-3 folds. Moreover, the cost of VAP has been projected to be an additional $40, 000 per hospital admission per patient and a projected $1.2 billion per year. The level of risk occurrence, increased costs and mortality necessitates implementation of measures to prevent VAP, everywhere feasible (Augustyn, 2007). A number of strategies have been proposed for VAP prevention however, only a few of them have proved their efficacy; others still need evaluation in large randomized clinical trials before accurate references can be made. In any case, antibiotic therapy will always remain the main stay of initiating VAP treatment and should be started as soon as the patient has been diagnosed with VAP and admitted to the hospital; other treatments whether single treatment or combination treatment should be initiated soon after. However, the varied amount of researches on VAP is often overpowering and contradictory. In some research, single treatment or monotherapy has been found to be a useful alternative to combination therapy, with the same achievement rate and without any superinfections or colonization by multiresistant pathogens. However, it was noted that most of these conclusions were arrived after observing patients who were diagnosed with VAP on merely clinical basis. Moreover, the efficiency of the treatment was simply based on information from tracheal aspirate instead of more explicit methods. In addition, on clinically studying 200 patients with P. aeruginosa bacteremia, it was revealed that the mortality rates for VAP patients undergoing monotherapy was 88% (7 out of 8 patients) whereas rate for those undergoing combination therapy was 35% (7 of 20 patients). Thus, it was concluded that the mortality rates in combination therapies are much lower than in the case of monotherapies (Chastre & Fagon, 2002, p. 892). Proposed solution The Ventilator care bundle is one of the six major programs that has been introduced and proven effective to prevent VAP. This approach includes a string of evidence based interventions associated to ventilator care, which when implemented together will achieve significantly better results than when applied separately. These evidence based strategies minimizes endotrachael intubation, the duration of mechanical ventilation and the risk of aspiration of oropharyngeal pathogens thereby leading to prevention of VAP to a great extent (Gillespie, 2009,p. 48). The Centers for Disease Control Guidelines and Pugin’s Clinical Pulmonary Infection Score criteria simultaneously noted that analyzing VAP needs a amalgamation of clinical signs, impaired gas exchange, radiological changes and positive microscopy to distinguish an occurrence of VAP from simple colonization. Specific guidelines have been developed to both prevent VAP and treat it appropriately as soon as possible. The guidelines provide ...Download file to see next pagesRead More
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