Ventilater Associated Pneumonia

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VENTILATOR ASSOCIATED PNEUMONIA: EDUCATION AND PREVENTION

A RESEARCH PAPER SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE MASTER OF SCIENCE BY MEGHAN CROCKETT BSN, RN, CMSRN DR. NAGIA ALI - ADVISOR

BALL STATE UNIVERSITY MUNCIE, IN DECEMBER 2011

Table of Contents Table of Contents…………………………………………………………………….….....i Abstract.……………………………………….……………………………………...….iii Chapter I………………………………………………………………………...………....1 Introduction…………………………………………….………………………….1 Background and Significance...………………………………...…………………3 Problem Statement……………………………………………………………...…5 Purpose…………………………………………………………………………….5 Research Questions………………………………………………………………..5 Conceptual Theoretical Framework…………………………………………….....6 Definition of Terms………………………………………………………………..6 Limitations………………………………………………………………………...8 Assumptions……………………………………………………………………….8 Summary…………………………………………………………………………..8 Chapter II………………………………………………………………………………...10 Literature Review…………………………………………………………………...10 Organizing Framework……………………………………………………………...10 Chapter III………………………………………………………………………………..34 Methodology and Procedures……………………………………………………….34 Introduction…………………………………………………………………………34 Research Questions…………………………………………………………………34 Population, Sample, and Setting…………………………………………………….35 Protection of Human Subjects………………………………………………………35

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Procedures…………………………………………………………………………..36 Instrumentation……………………………………………………………………..36 Research Design…………………………………………………………………….37 Intended Method for Data Anlysis…………...……………………………………..39 Summary…………………………………………………………………………....39 Reference……………………………………………………………………………...…40

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Abstract RESEARCH SUBJECT: Ventilator Associated Pneumonia: Education and Prevention STUDENTS: DEGREE: COLLEGE: DATE: Meghan L. Crockett BSN, RN, CMSRN Masters of Science in Nursing College of Applied Sciences and Technology December, 2011 Critically ill patients experiencing a life-threatening illness often contract ventilator-associated pneumonia (VAP). Subsequent aspiration of contaminated secretions along with colonization of the aerodigestive tract increases morbidity and mortality. As a result, there is an increased cost of health care that accounts for almost half of all infections in critically ill patients, increasing length of stay in the ICU. The purpose of this observational study is to determine whether an educational initiative decreases rates of VAP in ICU. This study is a replication of Babcock et al. (2004) study. The Guidelines for Prevailing Health-Care Associated Pneumonia (CDC) is the framework. A VAP educational program will be conducted for ICU nurses and respiratory therapists emphasizing correct practices for the prevention of VAP. The study will be conducted in two community-based hospitals in southern Indiana. Forty ICU nurses and twenty respiratory therapists will be offered a structured self-study module on risk factors for and strategies to prevent VAP. Ventilator-associated pneumonia rates will be monitored for six months. Findings will provide evidence for educational programs to help reduce VAP and reduce length of stay in ICU. The evidence will provide ways on how to reduce VAP with inadequate staffing and limited resources through continuing education.

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Chapter I

Introduction Ventilator-associated pneumonia (VAP) is the most common and lethal form of hospital-acquired (nosocomial) pneumonia, mostly occurring in Intensive Care Units (van Niewenhaven et al., 2006). It occurs in approximately 28% of patients who need mechanical ventilation for more than 48 hours. Forty-six percent of ventilated patients who develop VAP die while 32% of ventilated patients never develop it. The Institute for Healthcare Improvement (IHI) has targeted VAP prevention as one of six interventions for its 100K Lives Campaign, a national initiative to improve patient care and prevent avoidable deaths in hospitals (Pruitt & Jacobs, 2006). Predisposition factors for a patient...
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