Preventing Ventilator Acquired Pneumonia in the Acute Care Setting - Essay Example

"Preventing Ventilator Acquired Pneumonia in the Acute Care Setting" is a wonderful example of a paper on the respiratory system.
In the SRR review, the researchers selected 10 studies with the aim of reviewing their evidence in relation to the impact of ventilator care bundle on ventilator-associated pneumonia. The SRR researchers seem to be content with the evidence provided by the selected articles. However, other researchers such as Resar et al. (2005) feel that the evidence is not enough since the studies selected are not experimental. The articles are based on prospective observations done before and after the intervention. Research also argues that such researches lack bias control and that they do not develop a good causal link with the evidence being sought (Lawrence & Fulbrook, 2011).  

However, the SRR researchers do not uphold this view. Instead, they argue that prospective studies that are well-controlled tend to have stronger evidence than experimental studies. This is especially so since the phenomenon being measured is hard to be controlled in form of experimental designs. The SRR researchers also explain that the samples used in the selected studies are more representative than their experimental.

Therefore, two arguments stand out, the argument for prospective studies and the argument against prospective studies, The latter seems convincing enough because the level of evidence presented by the prospective studies as explained by SRR researchers is high. For example, some subglottic drainage, which is one of the pieces of evidence obtained after the usage of VCBs in ICU is high.

Rigor and Level of Evidence

The SRR researchers present the information with high levels of clarity. For example, the explanation of how the researchers were chosen for review and how others were excluded is clear enough. The researchers argue that some elements had to be included in the studies that would be selected in the SRR.

It is in this format that the reader gets a full picture of the studies, their outcomes, and how well they combined the ventilator care bundle elements for maximum results. The presented tables also show the outcomes of every study after the proper application of the VCB elements. Lucidity, in this case, is shown the capability of SRR researchers in reporting and summarizing data into several tables, which are comprehensible on the part of the researcher. The researchers not only maintain clarity when reporting but also maintain a high level of clarity when critiquing the studies. For example, the researcher s explains when the studies are lacking and when the studies are likely to produce maximum results (Lawrence & Fulbrook, 2011).

Summary of Overall Findings

The studies summarized in the SRR revealed that VCB elements, which include such things as multi-disciplinary teams and staff education when used alone or when used with other elements led to the reduction of VAP rates. Some of the other interventions on top of the bundled interventions included activities like constant glucose monitoring and feeding assessment among similar interventions. Some of the extra interventions were correlated with a high level of VAP reduction. For example, based on strong evidence presented by the selected studies, oral care seemed to have a great influence on VAP since the recorded reduction was at 30%.

The positive results associated with the VCB in relation to VAP reduction led to the conclusion that compliance is a vital factor since it highly impacts outcomes (Lawrence & Fulbrook, 2011).  

Another important finding was related to the collection of feedback. According to the researchers who conducted the SRR, feedback ranged from daily, weekly and monthly feedback. The latter was found to be more important as it was used to remind clinical staff that they are accountable and that they should focus on the intervention.

Other major findings were associated with the LOS or length of stay at the ICU and mortality rate. For example, a good number of the selected researches showed the LOS at the ICU decreased in a considerable percentage. Mortality and morbidity rate also decreased by up to 50% meaning that VCB interventions can be used to decrease the number of deaths related to VAPs.

Evaluation of the Conclusion: Implications for Research

The researchers conclude by stressing the limitation of the studies selected in explaining the causal link between VAP and VCB.  This limitation, according to the researchers, is related to the fact that the selected research uses an observational design. A comparison of this concluding statement with an earlier statement shows some disparities. Earlier on, the researchers had supported the validity and the usefulness of the evidence collected by comparing observational research with experimental design (Lawrence & Fulbrook, 2011).

Therefore, by stressing the limitation of observational design in the conclusion and at the same time supporting observational design, the conclusion can be said to be inconsistent with some parts of the research body. Apart from this part of the conclusion, other parts revisit the relationship between VAP and VCB. This helps the researchers to remain in line with the general format of writing a paper since the conclusion is supposed to revisit the themes and the major arguments presented in the body. Another role of the conclusion that has been perfectly employed is a recommendation. Apart from revisiting the entire document, the conclusion is supposed to have some presentations of the author’s or the researcher’s point of view in relation to the topic under discussion. For example, in the conclusion, the researchers recommend the use of VCB interventions among all ventilated adults who are in the ICU. The researcher also recommends high compliance since it helps in sustainable outcomes when using VCB interventions.

Conclusions are also used by researchers in identifying and explaining research gaps. The authors of the SRR article perfectly use this part to explain the gaps that exist in this research and how these gaps need to be filled. For example, the researchers explain that there are no researches that determine the best feedback strategies to use when applying VCB practices in order to reduce AP. By researching along these identified lines, the researchers can help in improving the clinical outcomes.