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Case Study: Ventilator Acquired Pneumonia

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Recommended: Review of literature of nosocomial infection

Identifying a Researchable Problem For this research project, I have chosen Ventilator-Acquired Pneumonia (VAP) among the intensive care patient population. This is a primary concern and prevention effort with intubated patients while in the intensive care unit. Patients in the intensive care unit often face many challenges during their stay. As an intensive care unit patient, they are often critically ill and are at a high risk for death; however, they are also at a high risk of death related to secondary complications often associated with nosocomial-acquired infection.
“The CDC defines VAP as hospital-acquired pneumonia that develops in patients who have been treated with mechanical ventilation for 48 hours or longer, but who had no signs or symptoms of lower …show more content…

The first question I generated addresses an intervention in the VAP bundle. For mechanically ventilated patients, what is the effect of elevating the head of the bed 30 degrees or more, in comparison to the head of the bed being less than 30 degrees, in preventing VAP? Often patients may have an injury that requires them to lay flat. Neck and hip injuries come to mind for those who cannot be elevated above 30 degrees.
My second question relates to an intervention of the VAP bundle. In the mechanically intubated patient, how does the use of chlorhexidine mouthwash, compared to the use of alternative oral care products affect the VAP bundle? There has been a big push towards oral hygiene care in mechanically ventilated patients. Through evidenced-based practice, this single intervention could significantly change the outcome. “Oral hygiene care, using mouthwash, gel toothbrush, or combination, together with the aspiration of secretions may reduce the risk of VAP in these patients” (Shi, 2013, p. 3). The chlorhexidine mouthwash was introduced in 2010 as part of the VAP

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Risk for Infection Next, by implementing the VAP bundle, it did help to prevent further decline. All aspects of the bundle should be continued; the Heparin, sequential compression devices, oral care, Pepcid, and all other bundle activities. Having the head of the bed up was essential to prevent VAP, but it did end up making her body move to the foot of the bed. Pillows were used to help keep her further up and off the side of the bed.

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It is JFK model risk assessment tool which includes every risk factors of the DVT. The JFK model risk assessment tool evolved through an evidence-based research and it proved that this model is working better than other models to assess the risk factors. Providing a valid and reliable tool for measuring the risk for DVT or PE in hospitalized patients will enable nurses to intervene early in patients at risk. Basing DVT risk assessment on the evidence provided in this study will assist nurses in becoming more confident in recognizing the necessity for interventions in hospitalized patients and decreasing risk (McCaffrey, R.,et.al. 2007). The table below is the DVT risk assessment tool made by this author based on the JFK model for the proposed

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