The most important intervention for preventing VAP, is avoid-ing intubation, by using noninvasive positive pressure ventilation whenever possible
It is important for nurses to recognize that the least invasive option is more beneficial to the patient's overall health journey. Using the least invasive option first can give the patient a quicker recovery time and leave them with the least amount of deficits. - GL, MI, ES
Over the past two decades, humanity has faced several viral outbreaks, causing severerespiratory syndromes, such as SARS-1, SARS-2 and MERS, which may have increasedthe percentage of intubated patients at a local leve
COVID-19 has increased the outbreaks of various respiratory disorders that have increased hospitalizations throughout the world. This has caused health care workers to look at what could be done to prevent further respiratory issues in already ventilated patients. Wearing PPE, suctioning frequently, and positioning the patient properly can all help reduce respiratory syndromes and distress. - GL, MI, ES
The studies with the highest rate of reduction [ 5, 19,25 ] implemented the “IHI Ventila-tor Bundle” combined with adequate ETT cuff pressure at 20–30 cm H2O and subglotticsuctioning.
This study is showing that the highest rate of reduction of VAP is contributed to maintaining adequate ETT cuff pressure at 20-30 cm and performing subglottic suctioning. These measures are taken to ensure the patient has a patent airway and does not choke on secretions. -GL, MI, ES
The second most widely usedintervention was oral hygiene using chlorhexidine 0.12%. Only one study [3] used sodiumbicarbonate and another one [33] sponges and mouthwashes, albeit without a particularchange in VAP reduction.
By providing oral care, nurses can prevent the incidence of thrush and bacteria that can grow in the patient's mouth which is unsanitary and can cause a multitude of other problems if there are open wounds/ulcers in the patient's mouth. - GL, MI, ES
After completing the checklist,all studies were classified as low risk, moderate risk, serious risk, critical risk, or “noinformation
Completing these steps are extremely important to maintaining the integrity of the study so that there are not any inadequate results or bias. - GL, MI, ES
n the last two decades, a major problem has been the increasing rates of occurrence ofcommunity-associated methicillin resistant Staphylococcus aureus (CA-MRSA) and hospital-associated MRSA (HA-MRSA). Apart from that, the communities have faced several viraloutbreaks, such as SARS-1, SARS-2, and MERS
Performing hand hygiene, wearing PPE, and actively participating in appropriate wound care techniques are all ways to decrease/prevent the spread of MRSA. Educate patients not to share razors or towels if diagnosed with MRSA. Patients' belongings should be kept secure and not shared with others. - GL, MI, ES
n 2016, the Intensive Care Society proposed a bundle called “Recommended bundleof Interventions for the prevention of VAP”, including elevation of head of bed, daily seda-tion vacation and assessment of readiness to extubate, use of subglottic secretion drainage,avoidance of scheduled ventilator circuit changes, oral hygiene without chlorhexidine andPUD prophylaxis (only for high-risk patients), without mentioning DVT prophylaxis.
By performing these interventions, we can help decrease the patient's risk for developing VAP. This can also lead to decreased lengths of mechanical ventilation. Elevating the head of the bed is crucial for preventing respiratory distress as this provides optimal positioning for lung expansion which works these muscles as prevents further medical problems. - GL, MI, ES
Ventilator-associated pneumonia (VAP) is one of the main types of infection in criticallyill mechanically ventilated patients, leading to increased mortality, morbidity, hospital stay,economic and psychological costs for patients and their families [1– 4].
Mechanical ventilation can pose a serious risk that contributes to ICU acquired weakness as well as delirium. Nurses can assist patients with early mobilization to decrease risk of VAP. - GL, MI, ES