Mouth Care to Reduce Ventilator-Associated Pneumonia Institution Mouth Care to Reduce Ventilator-Associated Pneumonia Introduction Ventilator associated pneumonia (VAP) is a hospital acquired pneumonia occurring within 48hours after the installation of mechanical ventilation with tracheal intubation…
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However, in most of the patients, the VAP is caused by a combination of organisms. The diagnosis of VAP is difficult, making it difficult to account for VAP incidences. The endotracheal tube increases the risks of VAP by prevention of cough, prevention of upper airways filtering and inhibition of epiglottis and upper ways reflex actions. The most risk patients are patients over the age of 65, with underlying chronic illness. This condition is also prevalent in patients with immunosuppressant and previous pneumonia infection. Oral hygiene The significance of a patient’s oral and nasal hygiene is overlooked in most cases, even though it is the most basic of all the nursing interventions. The use of closed suction system (CSS) contributes significantly to the reduction of these cases (Rello et al., 2010). The mouth is a host of both the normal flora and the pathogenic organisms. Most of the studies advocate the use of chlorohexidine. However, it is important to understand that overuse of this oral rinse could result in the reduction of the oral bacterial load. This could lead to the development of chlorohexidine resistant organisms. The common suction program can be used to reduce colonization. The installation of the endotracheal tube prevents the glottis closure. ...
Oral hygiene is significant in prevention of ventilator associated pneumonia (VAP) due to the oral factors, encouraging the colonization of the bacteria (Hutchins et al., 2009). For example, mechanically ventilated patients in neurological and intensive care units are at a higher risk of development of VAP due to factors such as decreased levels of consciousness, dry open mouth and the increased levels of micro aspiration of secretions. Several interventions could be adopted for the prevention of VAP. However, oral hygiene is one of the most important and significant intervention. The oral care includes timed tooth brushing, in combination with the other measures can be effective in the control of this condition. Some of the best practices include education of the staff on the effectiveness of oral hygiene in reduction of VAP incidences. The study should surround the factors surrounding the reduction of colonization and aspiration. In addition, avoidance of unnecessary antibiotics and nasal intubation in addition to oral hygiene can contribute significantly to the reduction of colonization. Maintenance of a clean healthy mouth through the prevention of plaque buildup biofilm on the teeth helps in reducing the risks associated with the development t of VAP. Oral hygiene care involves the use of mouth rinses, gel or toothbrush in combination to the aspiration of different mouth secretions can increase reduces the risk of infection with VAP. Previous studies revealed that the use of chlorohexidine mouthwash or gelled contributes to approximately 40% reduction in the chances of development of VAP (Reagan, 2011). Some of the best practices include education of the staff on effectiveness of oral hygiene in reduction of VAP
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The most significant clinical and economic impact of ventilator related lung infection is that a very large percentage of the population will develop this type of infection after oral intubation. Evidence-based research has shown that with some very simple basic mouth care techniques along with additional protocols, the number of patients diagnosed with ventilator associated pneumonia can be drastically reduced; normally within the first 24 hours of mechanical ventilation.
The VAP bundle includes four components of care and they are: 1. Elevation of the head of the bed of the patient This is the most integral part of VAP bundle and has been strongly associated with decrease in the rate of VAP. The elevation level that is recommended is 30-45 degrees.
It is a disease of the lung tissue occurring forty eight hours after procedures like tracheostomy or placement of an endotracheal tube to the patient is done. These procedures impair the integrity of the respiratory tree (CDC, 2012). Various journals have been published on other various VAP issues affecting its severity and outcome.
Ventilator acquired pneumonia (VAP) is pneumonia that occurs in patients on endotracheal intubation or tracheostomy tube after 48 hours or more which was not originally present before the ventilation. It is the most common ICU infection and the most fatal of all.
VAP is the commonest type of nosocomial infection, occurring forty eight hours after the initiation of mechanical ventilation. It affects between 10 to 20% of patients under mechanical ventilation. VAP leads to increased ventilator duration, increased hospital stays, increased mortality and increased cost.
Ventilator Associated Pneumonia (VAP) refers explicitly to nosocomial bacterial pneumonia that has developed in patients who are under mechanical ventilation. VAP can be segregated into two types – early onset pneumonia and late onset pneumonia. One that occurs within 48 to 72 hours after tracheal intubation and is mostly the result of aspiration is termed early onset VAP and the one that occurs after this period is termed late-onset pneumonia (Kollef, 2005).
The goal is geared towards the prevention of ventilator associated-pneumonia using ventilator bundle in long term care. The title of the project is Evidence-based Practice for the Prevention of Ventilator -associated Pneumonia using Ventilator Bundle in Long Term Care.
The main reason the patients on ventilator needs to be monitored and managed with dexterity is ventilator associated pneumonia (VAP), which adds to the morbidity and mortality statistics associated with ventilator management and hence this condition needs to be prevented (Fagon et al., 1996).
This becomes more relevant in a district hospital working in the capacity of a critical care nurse, where supports from the specialist care professionals are less available, and where the nurses in the critical care need to take clinical decision on their own (Walsh et
rts (American Thoracic Society, 2005) exhibit that over three million individuals develop pneumonia yearly while 17% of the victims receive treatment in hospitals. Therefore, most victims recuperate, making it apparent that at least 5% of the patients always accede the illness
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