VAP reduction rates differ between the different types ofICUs (medical, surgical, cardiovascular)
It may be difficult to implement one national bundle. However, simple tasks like oral care and HOB elevation can be easily nationally implemented and should be basic interventions depending on the patients condition. VT
We assume thatmeasures such as hand hygiene and aseptic suctioning technique are of the most basictechniques and that they were taken for granted, along with all the other interventionsfor VAP prevention in the included studies
I think a lot of people and organizations would take these measures for granted. Like I stated earlier, hand hygiene is the number one way to prevent infection. Implementing this from the start is crucial. VT
Oralcare remains an important tool for dental plaque removal and the promotion of a normalmicrobial community inside the oral cavity, thus preventing the growth of microorganismsin the trachea
Oral care should be implemented regardless if they are intubated or not. Often times I have seen patients go too long without oral care, so that is something that needs to be stressed more in these settings. VT
preventing VAP, is avoid-ing intubation, by using noninvasive positive pressure ventilation whenever possible
If intubation can not be avoided it is important to look at the readiness to extubate at a timely manner to prevent VAP from occurring. VT
VAP diagnostic criteriadiffer among ICUs but usually require factors such as fever, leukocytosis, progressiveinfiltrate on chest X-ray, positive cultures from respiratory secretions and reduction in gasexchange
These symptoms are important to know to recognize and stop the progression of VAP. They are similar to other signs of infection as well. VT
ombined measures can prevent VAP toagreater extent.
combining the bundles and interventions amongst them can create a great effect in reduction of VAP versus just implementing one bundle over another. VT
hand washing
hand washing still poses as the number one way to prevent the spread of infection should be continued to be implemented no matter what. VT
highest rate of reduction [ 5, 19,25 ] implemented the “IHI Ventila-tor Bundle”
This IHI Ventilator Bundle produced the greatest reduction in VAP. I think this shows the importance of implementing these easy yet effective measures to patients. VT
Head-of-Bed elevation, with a range of 30◦ to 45◦
HOB elevation is recommended not only to prevent VAP but also help respiratory efforts in other situations as well. VT
hestudied populations were critically ill ventilated patients admitted to general, medical,surgical, neurosurgical, trauma, and cardiovascular ICUs
These studies taking place across multiple ICU settings shows how VAP could spread across a range of patients. VT
preventive measures for VAP reduction
A required bundle that is similar across multiple health care organizations should be implemented to effectively reduce the risk of VAP. VT
readiness to
The readiness to extubate is something I have seen become more prominent in clinical. Patients ideally should not be intubated for more than 14 days. This can improve the patients airway and ultimately reduce the risk of VAP. VT
sedation andweaning protocols, semi-recumbent positioning, oral and hand hygiene, peptic ulcer disease anddeep venus thrombosis prophylaxis, subglottic suctioning, and cuff pressure control. Head-of-bedelevation was implemented by almost all studies, followed by oral hygiene,
These components are critical to implement for these ventilated patients. In clinical, I have provided oral care and suctioning to patients on the ventilator. Seeing what the vent can do to their oral cavity shows how much and how easily bacteria could spread. VT