Ventilator-Associated Pneumonia - Essay Example

Research Article Appraisal Research Article Appraisal Study outcomes show that there are high chances of developing Ventilator Associated Pneumonia if one is exposed to pathogenic oral bacteria. According to the article, critically ill patients in ICUs are more vulnerable to the disease causing oral bacteria. Researchers believe that there is a positive correlation between the Ventilator Associated Pneumonia in critically ill neuroscience patients and oral health. Study problem p.369 High concentration of pathogenic oral bacteria increases one’s risks of getting Ventilator Associated Pneumonia (VAP). The condition occurs when there is no balance between pathogenic and gram-positive bacteria. Failure to maintain the balance can cause disease-causing bacteria to attack the respiratory tract after replacing the gram-negative bacteria within a period of two days. Previous studies have not identified the effects of oral health on critically ill patients. The aim of this study is to examine the impact of oral health by describing changes that occur during intubation especially the development the pneumonia (Prendergast, Hallberg, Jahnke et al 2009, p. 369). Review of literature p.369 The major focus of the literature review in the study is to explain the effects of oral health using previous studies. It also focuses on explaining the magnitude of the problem through statistics. The literature review of this study is well connected to the research questions. For example, researchers have provided various examples of how oral health affects the respiratory tract of the critically ill elderly patients in other studies. The progressive development of ideas based on previous research has helped in proving to the audience the need to conduct the study. For example, through the literature review, the researchers have explained aspects already known. They have also indicated that their research questions have not been answered by other studies. This has helped in showing the gaps that the researchers are intending to bridge using the study. For example, the literature review indicates that studies about the effects of oral health on systemic health have already been conducted. However, no study shows the effects of oral health on patients with neuroscience conditions. In addition, the literature review contains enough information that enables the audience to learn about the topic (Prendergast, Hallberg, Jahnke et al 2009, P. 369). Methodology p.370 The design is quantitative because the researcher wanted to study the relationship between oral health and the Ventilator Associated Pneumonia. The type of quantities design used is descriptive because the only aim of the study is find out the connection between variables. In addition, the study is dependent on observed features. The researchers only observed the effects of oral health of the subjects without intervening. The study was prospective because variables such as oral health were studied at the beginning of the study. At the end of the study, the outcomes were determined. The study also contains a description of the sample characteristics. The researchers selected 45 subjects in the sampling process. They only selected patients in the ICU units. They chose the ICU in US Southwest. The hospital specializes in treating patients with neural science conditions in the region. They selected subjects with critical health conditions such as stroke, traumatic brain problems, and brain tumor. Power analysis was used in determining the size of the sample (Prendergast, Hallberg, Jahnke et al 2009, P. 370). The researchers used various instruments to collect data in the study. For instance, questionnaires were used to collect information about the age of patients, sex, and other demographic information. They also recorded other observed information such as the duration of stay in the hospital, body temperature, and blood cell counts. Radiographic instruments were also used to observe the chest conditions of the subjects. Information about the oral health of patents was collected using the Oral Assessment Guide (OAG). The oral health of the patients was studied after every 72 hours based on items such as voice of the patients and their saliva. The researchers used the Cronbach alpha coefficient in order to show internal uniformity (Prendergast, Hallberg, Jahnke et al 2009, P. 370). Data analysis p.371 The statistical analysis used in the study is the SPSS. The observation time was 10 days for each patient. Patients who stayed in the hospital for more than 10 days were eliminated from the data analysis. The VAP criteria were divided into two groups that consisted of patients with no VAP and those with high probability of having VAP. They observed the presence or absence of bacteria regularly. The analysis answers the research questions effectively. The questions included finding out weather oral health increases VAP. For example, the oral health analysis showed an increase of OAG from 12 to 16 per day. The findings indicated a deterioration of oral health for the critically ill patients. The analysis of the gram-negative bacteria on the patients showed that during the enrollment, bacteria were 22 percent. By the end of 10 days, the bacteria had increased by 50 percent. The analysis of the Ventilator- Associated Pneumonia (VAP) indicated the increase in VAP probability. For instance, in the first four days of the study, the probable VAP developed in 11 patients while 31 patients developed VAP on the eighth day (Prendergast, Hallberg, Jahnke et al 2009, p. 371). Discussion of findings p.372 The findings of the study proved a strong connection between oral health and intubation period. It implies that prolonged intubation causes a deterioration of oral health. The process indicates that hospitals have to improve oral care hygiene in order to promote oral health. In addition, the findings showed that the scores of OAG indicate a deterioration of oral health that was seen through the worsening medical conditions. The tests of saliva and other study items also indicated that the health conditions of subjects became worse as their intubation period increased. The unique finding of the study was the increase in VAP probable as patients stayed longer in hospitals. The discussion section of the study shows that the researchers effectively discussed the findings of their study based on the hypothesis and research questions. Research questions were answered appropriately in this section (Prendergast, Hallberg, Jahnke et al 2009, P. 373). The conclusions of the study are reasonable. The researchers have also not concluded beyond the findings. However, they do not effectively summarize the findings of the study. In addition, they do not restate the relationship between variables in the study. The strength of the study is the use of appropriate data collection and analysis methods. The researchers have also identified the limitations of the study. For instance, the study used a very small sample size. In addition, the study was only done in one hospital. For this reason, it is difficult to generalize the results of the study to other situations (Prendergast, Hallberg, Jahnke et al 2009, p. 375). Conclusion The findings of this study are helpful in the healthcare management practices. For instance, they give directions on how hospitals should maintain oral hygiene in order to prevent gram-negative bacteria. They also provide knowledge about the effects of oral health on critically sick patients. The findings may also influence policies since maintenance of oral hygiene should be one of the hospital requirements. The researchers recommend further study on the best oral care practices for hospitalized patients. References Prendergast, V., Hallberg, I., Jahke, H. et al. (2009). Oral health, ventilator-Associated pneumonia, and intracranial pressure in intubated patient in a neuroscience intensive care unit. American Journal of Critical=care nurses, 18 : 368-376. Read More