PROBLEM, PURPOSE, AND THE QUESTION - Essay Example

Problem, Purpose, and Question XXXXX Grand Canyon HLT 490 Problem, Purpose, and Question The problem identified is the increasing incidence of ventilator-acquired pneumonia in the healthcare settings. Ventilator-acquired pneumonia (VAP) is the most common type of nosocomial infection that occurs 48 hours after initiating mechanical ventilation and which affects approximately 10-20% of patients in United States under mechanical ventilation (Vincent, Barros & Cianferoni, 2010, 1927). Failure to prevent or manage ventilator-acquired pneumonia has been associated with increased ventilator time and hospital stays, increased cost, and increased mortality.

In fact, Keeley (2007) stated that VAP exceeded all types of infection and is considered as the leading cause of death among all types of nosocomial infection. Combination of the preventive and management strategies is the purpose of the said problem and healthcare facilities need to determine the efficacy of each strategies or its combination to reduce the mortality and problems associated with VAP. Thus, the author of this paper wants to know the effectivity of each strategy or the combination of both preventive and management strategies known as “ventilator bundles.

” By researching the issue and developing a correct question, a resolution could be made to improve patient outcomes.Patient Care Quality Problem Patients often sought treatment or combination of treatments which are effective and contributory to early recovery. Being in the intensive care units is stressful to both the patient and family; thus, it is essential that facts about the treatment and its efficacy must be communicated to the healthcare settings, staff, family, and patients. Normally, patients go to a hospital with a cost-effective treatment and low prevalence of VAP.

In addition, patients’ selection and decision to stay in a treatment depends on its effectivity. If the selected treatment does not contribute to patients’ recovery, they are likely to try a combination treatment or a new one. According to Arroliga et al. (2012), ventilator bundles (combination of VAP practices that include head elevation, daily sedation, assessment of readiness to extubate, and prophylaxis for peptic ulcer disease and deep vein thrombosis) are evidence-based practices and multidisciplinary approaches that are held responsible for the reduction of VAP in the United States and in improving health outcomes (p. 688). Resolution To resolve the problem of increasing incidence of ventilator-acquired pneumonia in healthcare settings, clinical trials must be conducted to determine the efficacy of each treatment and its combination.

Results of the trials must be published on a well-known journal, websites, or media for the public to become aware of the effectivity of each treatment or combination treatments. Likewise, patients must be educated about the treatments and be allowed to choose what certain treatments or combination bundles could work for them.Purpose The purpose of conducting clinical trials is to determine which preventive or management strategy works best in reducing ventilator-acquired pneumonia. Conducting clinical trials will also determine whether combination treatments are cost-effective than single treatments.

No study is complete until findings or results are shared to others (Polit & Beck, 2008, 691). A researcher has the responsibility to disseminate results to promote the general welfare of the public. The researcher can do this by oral or written presentation but the latter which includes theses, dissertations, journal articles, and outlets on the Internet are much more preferred because of ease of access worldwide. Thus, to disseminate results of which is better among single and combination therapies in reducing VAP, written presentations have the capacity to reach larger population.

Educating patients about each treatment is also a must and a part of ethically-focused care. According to Melnyk & Fineout-Overholt (2006), consumers of health care services want to participate in the clinical decision-making process particularly with regards to treatment decisions (p. 12). Answerable Question PICO question facilitates optimization and application of evidence-based practice (Chiappelli, 2010, 68). Formulating a PICO-format question is also the first step of an evidence-based practice.

In line with the problem, purpose, and resolution identified, the author has come up with the research question as follows: In ICU adult patients receiving mechanical ventilation after 48 hours (P), does combination treatment or ventilator bundles (I) compared to traditional single treatment (C) lead to reduced incidence of ventilator-acquired pneumonia (O)?Evidence-based resources Databases and professional heath organizations are important evidence-based resources, as well as bibliographic and web-based sources and appropriate peer-reviewed journals (Newhouse et al.

, 2007, 68). Websites ending in “dot gov” such as guideline.gov, cdc.gov, dhhs.gov are considered as credible resources. When it comes to topics concerning health, a researcher could also seek the website of the department of health. Evidence-based resources are essential components of any research or study as it reflects the credibility of a study applied through presentation of evidences. A good evidence-based resource should be up-to-date, relevant to the public health interest, and justify the agreement or contradiction to certain practice in nursing.

For instance, for ventilator bundles to be considered better than single treatment, evidences must be recently published on a credible website or journal and can explain comprehensively how VAP is prevented in two set-ups.Conclusion Conducting clinical trials is essential in determining the effectiveness of a treatment. With this, patients are given more options of the treatment that is both cost-effective and quality-focused. Through implementation of ventilator bundles, the incidence of VAP in the United States is declining; thus, comparative studies must be conducted in a larger sample with different demographic characteristics in order to generalize the findings to the overall population.

The author is aware that not all part of the ventilator bundles are implemented in the healthcare settings which led to the examination of the effectivity of each preventive or management strategy. Using the evidences and the result of possible study, this knowledge could be used to reduce the incidence of VAP among adults in the ICU settings and improve the quality of life.ReferencesArroliga, A.C. et al. (2012). Reduction in the incidence of ventilator-associated pneumonia: A multidisciplinary approach.

Respiratory Care, 57(5): pp. 688-696.Chiappelli, F. (2010). A Model for Implementing Evidence-Based Decisions in Dental Practice. Evidence-Based Practice: Toward Optimizing Clinical Outcomes (p. 67-78). New York: Springer Publishing, Inc.Keeley, L. (2007). Reducing the risk of ventilator-acquired pneumonia through head of bed elevation. Nursing in Critical Care, 12(2): pp. 287-294.Melnyk B. & Fineout-Overholt E. (2006). Evidence-based practice in nursing and healthcare: A guide to best practice.

Philadelphia: Lippincott Williams & Wilkins. ISBN-13: 9780781744775.Newhouse, R.P. et al. (2007). Searching for Evidence. Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines (p. 59-74). Indiana: Sigma Theta Tau International.Polit, D.F. & Beck, C.T. (2008). Disseminating Evidence: Reporting Research Findings. Nursing Research: Generating and Assessing Evidence for Nursing Practice (8th ed.) (p. 691-711). Philadelphia: Lippincott Williams & Wilkins.Vincent, J.L., Barros, D.S. & Cianferoni, S. (2010). Diagnosis, management and prevention of ventilator-associated pneumonia.

Drugs, 70(15): pp. 1927-1944.