Case Study: Ventilator Acquired Pneumonia

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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
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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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