Ventilator-Associated Pneumonia (VAP): Nursing in the ICU - Essay Sample

Introduction

There is a need for transformational change within the healthcare system. Nurses are tasked with responding to their patients’ needs. Having worked in a general healthcare facility, one clinical practice problem that nurses need to be knowledgeable about is the prevention and control of ventilator related infections. One such infection is ventilator-associated pneumonia (VAP). Evidence-based resources reveal the problem of VAP and how nurses in the ICU can prevent and control the infection. The purpose of this paper is to describe the problem, effects, solution, implications for nursing practice, and how it affects nursing.

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Problem Statement

VAP can cause serious consequences for patients. Wu et al. (2019) described VAP as acquired pneumonia that occurs 48 hours after mechanical ventilation. In 2015, the Centers for Disease Control and Prevention (CDC) surveyed acute care hospitals across America and found that pneumonia was the common infections and that 32% were ventilator-associated (Centers for Disease Control and Prevention, 2020). VAP is a cause of high mortality rates in the hospital since nurses are sometimes unable to prevent and control the infection.

Setting

VAP can occur in various settings in the hospital. CDC (2020) indicated that VAP is available in inpatient pediatric and adult locations such as the ICU, step-down units, long-term care units, and wards. Nurses working in those locations need to conduct surveillance on the occurrence of VAP. The rate of VAP in adult locations is higher than in pediatric locations (Kohbodi, 2020). Hospital surveillance of a ventilator-associated event (VAE) is necessary for these settings to prevent and control the infection in patients.

Description of the Problem

Mechanical ventilation is an intervention that can help to save patient’s lives. In the process of ventilation, however, patients might acquire pneumonia. In 2016, the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) reported that in America, the mortality rate for VAP was 13% (Wu et al., 2019). Also, Fernando et al. (2020) stated that the diagnostic procedures to prevent and control VAP are challenging among nurses because VAP is hard to identify. Evidence-based resources can help in the prevention of VAP.

Effect of the Problem

VAP has adverse effects on patients. Taminato et al. (2019) indicated that VAP causes increased mortality, increased length of stay in the ICU, and increased healthcare costs in the hospital. More so, the authors stated that mechanical ventilation worsens the respiratory system causing lung inflammation and infection, which causes conditions of VAP. The compliance of health professionals, however, can help to prevent these effects.

Significance of the Topic and Implications for Nursing Practice

The topic is significant because it would help nurses to learn the prevention and control strategies for VAP. Arzouman (2015) talked about evidence-based inquiry, which is significant among medical-surgical nurses. The spirit of inquiry helps to solve critical clinical problems (Arzouman, 2020; Stillwell et al., 2010). The topic of VAP has implications for nursing practice. Healthypeople.gov (2020) talked about educational and community-based programs that help to prevent diseases, improve health, and enhance the quality of life. Undoubtedly, the topic would help nurses to employ best practices in preventing and controlling VAP.

The Proposed solution to the problem and how it affects Nursing

The proposed solution to the problem is good practice. Taminato et al (2019) stated that the development of good practice and training of a multi-professional team in prevention and control strategies would help to reduce incident rates. Additionally, Wheatley et al. (2017) affirmed that patient-centered care and coordination among health professionals would help to improve healthcare outcomes. Furthermore, Papazian et al. (2020) asserted that the best prevention for VAP is to reduce exposure to invasive ventilation by using high flow oxygen and prompt early extubation. The solution would improve nursing practice as the staff would manage to provide integrated, comprehensive, and quality care to patients with mechanical ventilation.

Conclusion

One of the frequent infections in healthcare is VAP. Its effects on patients are adverse. Therefore, nurses working in settings that require VAP need to take active measures with evidence-based practices and resources to prevent the occurrence of such an event.

Referencess

Arzouman, J. (2015). Evidence-based practice Share the spirt of inquiry. MedSurg Nursing: Official Journal of the Academy of Medical-surgical Nurses, 24(4), 209–211.

Centers for Disease Control and Prevention. (2020, January). Pneumonia (Ventilator-associated

[VAP] and non-ventilator-associated Pneumonia [PNEU]) Event. https://www.cdc.gov/nhsn/PDFs/pscManual/6pscVAPcurrent.pdf

Fernando, S. M., Tran, A., Cheng, W., Klompas, M., Kyeremanteng, K., Mehta, S., English, S.

W., Muscedere, J., Cook, D. J., Torres, A., Ranzani, O. T., Fox-Robichaud, A. E., Alhazzani, W., Munshi, L., Guyatt, G. H., & Rochwerg, B. (2020). Diagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis. Intensive care medicine, 46(6), 1170–1179. https://doi.org/10.1007/s00134-020-06036-z

Healthypeople.gov. (2020, August 18th). Educational and community-based programs. https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs

Kohbodi, G.A., Rajasurya, V., & Noor, A. (2020). Ventilator-associated Pneumonia. In:StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507711/

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated pneumonia in adults: a narrative review. Intensive care medicine, 46(5), 888–906. https://doi.org/10.1007/s00134-020-05980-0

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence based practice, step by step: asking the clinical question: A key step in evidence-based practice. The American journal of nursing, 110(3), 58–61. https://doi.org/10.1097/01.NAJ.0000368959.11129.79

Taminato, M., Belasco, A. G. S., Barbosa, D., Kusahara, D. M., & Fram, D. (2019). Good practices in the prevention of ventilator-associated pneumonia. Acta Paulista de Enfermagem, 32(1). https://doi.org/10.1590/1982-0194201900003

Wheatley, L., Doyle, W., Evans, C., Gosse, C., & Smith, K. (2017). Integrated comprehensive care - A case study in nursing leadership and system transformation. Nursing leadership (Toronto, Ont.), 30(1), 33–42. https://doi.org/10.12927/cjnl.2017.25107

Wu, D., Wu, C., Zhang, S., &Wong, Y. (2020). Risk factors of Ventilator-Associated Pneumonia in critically ill patients. Frontiers in Pharmacology, 10(482). https://doi.org/10.3389/fphar.2019.00482