The Issue of Mechanical Ventilated Treatment among the Elderly - Literature review Example

Background The growing demands of improved health care facilities and services has put a lot of pressure on scientists and relevant authorities to introduce effective interventions so as to overcome the challenges associated with emerging diseases. According to Smeltzer et al. (2008) the physiological changes that human beings experience over time due to environmental impacts and lifestyle change, greatly influence the well-being of an individual. As a result, human beings are faced with foreign ailments every day, thus calling for further research to ensure that there is proper and effective medication which patients can be able to afford. Evidently the elderly tend to have a weak immune system as compared to people of other age groups. Weinclaw (2015) affirm that the elderly physiological structure deteriorates since this group of people become less active which is as a result of the natural decline of the body mechanisms. This research question is going to focus on addressing the issue of mechanical ventilated treatment among the elderly, its impacts on patients’ recovery process, health workers’ health and its financial costs. This paper used literature that discussed some of challenges arising from mechanical ventilated treatment so as to address the research question. Data and information from these literature articles is used to provide extensive insight on this treatment technique as well as educate both patients and health workers on the risks associated with it. Most of the data collected from these literature articles vividly elaborate the two systems of suctioning, open and closed suctioning system. By comparing these two systems, the paper is able to narrow down the impacts that the open and closed suctioning systems has on patients’ recovery process, the costs associated with them and their effectiveness for health workers during the administration of medication. This has been achieve by analysing some of the diseases contracted through airways such as pneumonia as well as evaluating the risks of contamination in health care facilities due to the use of these suctioning systems. Further this research paper will compile information from all the relevant literature articles and sources and use previous studies on the same subject as a means to provide effective and conclusive information that can be used at a local and international level during mechanical ventilation treatment. Summarise Four Primary Research Articles Paper 1 In this research paper the authors Jongerden et al. (2011) examined the impacts that the open and closed suction systems had on patients. This study analysed these two system and aimed at providing conclusive literature on which of the two methods placed patients at a higher risk of contracting gram-negative bacteria at the ICU. The theory underlying this research is that the number of patients exposed to the gram-negative infections among patients who are admitted in mechanically ventilated environments in the intensive care unit has not received the attention it requires. During this research the authors, based their findings on patients’ responses to both systems whereby they incorporated a prospective crossover study in four distinct intensive care units. A total of 11, 000 patients took part in this study with 585 being of the closed suction system and 525 of the open suction system. The statistical evidence revealed by this research was able to show that the closed suction system was not really effective in reducing the risk of patients in the intensive care unit form contracting the Gram-negative bacteria as compared to the open suction system. The cross-transmission rate of the gram-bacteria was 5.9 for the patients placed under the closed suction system and 4.7 for those placed under the open suction system. A microbiology and genotyping test on the patients, showed that patients were exposed at a greater risk of acquiring hazard species such as the Pseudomonas aeruginosa, Enterobacter and Acinetobacter, thus rendering this system ineffective as opposed to the open system unit (Jongerden et al. 2011). Paper 2 This study conducted by Lorente et al. (2005) focused on comparing the prevalent nature of ventilator-associated pneumonia among patients who are placed under the open-tracheal and closed-tracheal suction systems. The methodology used was a quantitative approach whereby the authors employed a prospective and randomized study. 443 patients participated in this study with 210 taking part in the closed suction system while 233 took part in the open suction system. As a procedure to collect data, the researchers collected throat swabs from patients once one was admitted. Throughout the study these samples were collected twice a week among patients until one was disgorged. According to Lorente et al (2005) this technique was implemented as a means to enable the researchers to classify the type of pneumonia in terms of endogenous or exogenous. The evaluation of the results gathered based its findings on the sex, age, diagnosis as well as the overall physical and chronic health evaluation of a patient. The findings from this research revealed that the open and closed tracheal systems did not show any significant changes in reducing the rate of ventilator-associated pneumonia among patients. However, closed-tracheal suction system proved to be very costly for patients and their relatives (Lorente et al. (2005). One of the limitations noted in this research was the irregularity in collecting data. Despite the fact that patient duration at the hospital played a significant factor in this study, Lorente et al. (2005) did not recognize this. The research incorporated data that was collected form patients that were admitted and discharged on different occasions, hence showing that the scope of the research was limited. Paper 3 This study by Akerman et al. (2014) is a comparative study whose main aim was to evaluate how closed suction systems influences ventilator-associated Pneumonia. The theoretical framework for this research work is that the closed suction system works effectively if it is treated as a prophylactic measure. Akerman et al. (2011) argue that there is a significant reduction in the number of patients suffering from ventilator- associated pneumonia if a prophylactic treatment measure is introduced. During the research, data was collected from in two intervals once a month for a period of four months. This technique involved a reversal procedure whereby patients were put on a closed and open suction system in intervals and data collected for each system, whereby during the closed suction system, a catheter tip was cultured into the system. Akerman et al. (2014) affirm that the data collected was critically evaluated and a descriptive conclusion provided, so as to enable the researchers to compare data from each system. The findings from this research showed that the closed suction system exposed patients to high risks of contaminations since patients experienced difficulties in secretion clearance. Akerman et al (2014) affirm that implementing an airway system into these two suction systems did not have any significant impacts on patients whatsoever. However, patients under the closed suction system scored highly in the Simplified Acute Physiology Score, thus affirming that the closed suction system is rather effective when accompanied with a prophylactic treatment such as the manipulation of airways as seen in this study. Paper 4 This research study by Ricard et al. (2011) is a comparative investigative research that analyses the impacts the open and closed suctioning system on the equipment used by health care workers and their health during tracheal suctioning. The main objective of this study was to evaluate how these two systems are able to contribute to infections contracted by health care workers as they treat a patient under the care of open or closed suctioning system. According to Ricard et al. (2011) tracheal suctioning increases cross contamination in the intensive care unit hence the study focused on identifying which of the two systems would reduce contamination of equipment and workers. In comparing the effects of the two suctioning systems, the research adopted the used of multidrug- resistant pathogens so as to compare the results from the two suctioning systems. Findings from this study revealed that the closed suctioning system was the only one that registered a significant difference in reducing the contamination of health care workers as well as an institution’s equipment. Therefore the closed suctioning system should be implemented by health care facilities during a tracheal suctioning as a means to reduce cross contamination. The systematic use of closed suctioning system proved to drastically reduce contamination in airway tubes as well as health workers’ gloves (Ricard et al. 2011). Discussion The four research sources discussed above all aimed at identifying the effective nature of the open and closed suctioning system for patients under the mechanical ventilated treatment technique. In order to evaluate the impact that each system has on health care, the researchers adopted a comparative measure. This is achieved by collected data from both patients put under both systems and analyse them so as to have an extensive understanding of the end results. These four sources are relevant to the research question above as they are able to provide extensive literature on mechanical ventilation treatment. In each of these papers the authors have conducted a comparative research focusing on closed and open suctioning systems which are proposed medical intervention measures for improving treatment for mechanical ventilated patients. Although the authors from each of the papers uses different approaches to arrive at the conclusions, the main objective is to identify which of the two systems is more effective and affordable for patients. The four literature materials used in this studies are all from different years which is important for this study to be able to compare the findings and also identify factors that have interfered with previous and current results. According to Kothari (2011) research is a progressive study methodology and therefore studies conducted on a given topic should be able to use methods that are up to date and are relevant to the current events. Therefore in conducting medical studies, one is urged to observe the current standards or policies that are applicable to the particular study or research. Evidently the basis of research work in any medical field, is a practical step for practioners to implement effective routines and policies for improved health care facilities and treatments. This research paper adopted both qualitative and quantitative research materials as the foundation of gathering data and information. This is because the data provided in this research paper aims at solving both local and international medical complications that may arise from mechanical ventilation treatment. Bulechek et al. (2013) affirm that an informative research technique in the medical field acts as a link in addressing current and future challenges in the field of medicine. Thus research contributes to the growing interests by professionals to observe and make inquiries pertaining certain issues which with effective strategies that will improve the well-being of individuals (Kumar, 2008). Notably, this research not only aims at providing an effective medical administration technique for the elderly but also looks at enhancing research work in the area of mechanical ventilation treatment. According to Koutoukidis et al. (2008) research in medical studies use evidence-proof practices as a means to improve patient care. Therefore as part of conducting research work in the field of medicine, practioners are urged to employ safe and effective measures that reach clinical standards in their practice. From the four research articles, the authors were able to adhere to the research practices above in providing conclusive data on the topic. The conclusions from these research papers revealed that open and closed suction systems have pros and cons. However the cons associated with closed suction system outweigh some of the cons identified in the open suction system. Each of the systems is effective in one area and ineffective in another. Overall, the closed suction system is ruled out as the most costly of administering medication. Conclusion Closed and open suctioning systems are medical practices that are aimed at improving the health of patients under mechanical treatment. This research aims at providing extensive literature on the two systems. The information provided will be used in identifying which of the two systems is affordable and effective in reducing the risks associated with mechanical ventilated treatment and improving patients’ progress. References Åkerman, E., Larsson, C. & Ersson, A. (2014) 'Clinical experience and incidence of ventilator‐associated pneumonia using closed versus open suction‐system'. Nursing in Critical Care. vol. 19, no. 1, pp. 34-41. Bulechek, G. M., Butcher, H. K., & Dochterman, J. M. (eds). (2013). Nursing interventions classification (NIC), 6th edn. St. Louis, Mo: Mosby. David, D., Samuel, P., David, T., Keshava, S. N., Irodi, A. & Peter, J.V. (2011). 'An open-labelled randomized controlled trial comparing costs and clinical outcomes of open endotracheal suctioning with closed endotracheal suctioning in mechanically ventilated medical intensive care patients.’ Journal of Critical Care. vol. 26, no. 5, pp. 482-488. Jongerden, I., Buiting, A., Leverstein-van Hall, M., Speelberg, B., Zeidler, S., Kesecioglu, J., & Bonten, M. (2011). ‘Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: A prospective crossover study.’ Critical Care Medicine. vol. 39, no. 6, pp. 1313-1321. Kothari, C. R. (2011). Research Methodology Methods and Techniques, 2nd edn. New Delhi: New Age International Ltd. Koutoukidis, G., Lawrence, K. & Tabbner, A. R. (2008). Tabbner's nursing care: theory and practice, 5th edn. Chatswood: Churchill Livibgstone/Elsevier. Kumar, R. (2008). Research methodology. New Delhi: S.B. Nangia, Lorente, L., Lecuona, M., Martín, M. M., García, C., Mora, M. L. & Sierra, A. (2005). 'Ventilator-associated pneumonia using a closed versus an open tracheal suction system.' Critical care medicine. vol. 33, no. 1, pp. 115. Ricard, J., Eveillard, M., Martin, Y., Barnaud, G., Branger, C. & Dreyfuss, D. (2011). 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