Ventilator Associated Phenomenon: A Case Study

Reflect upon the clinical problem that you have identified in your area of nursing practice (as identified in Module 1). Critically appraise the research and summarize the knowledge available on the clinical problem.

The objective of this paper is to discuss the benefits of implementing a sepsis bundle focusing on the SSC recommendations and the improved effects realized on patient outcomes and morality rates. The clinical question is as follows: In acute care adult patients, what is the effect of implementation of a sepsis bundle compared to no bundle on patient

In the case study, it shows that the nurses did not treat the patient according to his/her needs. The nurses have failed to deliver an ongoing assessment of the pressure area, and this has resulted in harm to the patient.

The use of evidence based practice in the hospital setting is increasing since research proving that integration of evidence based healthcare has a lot of benefits in this setting, and achieves the best possible outcomes for the patient . Improved patient outcomes is a result of the higher quality of care given by providers when following the most recent and updated evidence of the effect of care at the point of care. Utilization of evidence based practice also increases clinicians confidence in their care, allows them to adapt to new care, improve their skills, as well as their critical thinking and decision making skills. This in turn leads to higher clinician job satisfaction which promotes improved care of the patients through improved

In the review of the literature regarding National Patient Safety Goals and the reduction of healthcare associated infections by the implementation of evidence-based practice, one article addressed the education of patients and family to prevent catheter-related bloodstream infections (Dela Cruz et al., 2012). MD Anderson Cancer Center Infusion Therapy Team places 600 central venous catheters (CVC) and PICC’s and 100 implanted ports each month at their facility (Dela Cruz et al., 2012). Volume like this has lead to an extensive formal education program to assist the patient and family with care and maintenance of their CVC to reduce the number of catheter-related bloodstream infections (Dela Cruz et al., 2012). The education program consists

Her medical diagnosis of ARDS from overdosing and pneumonia are the cause of her deteriorating condition. Then, it moves on to the first two primary nursing diagnoses of impaired gas exchange and risk for infection, followed by the lower ranked ones of impaired tissue integrity, anxiety, and finally decrease cardiac output. The case study then explored her expected outcomes, the interventions used for her primary two nursing diagnoses with literature reviews, and finally an evaluation of the plan of care. The learning from this patient is that it is not our place as nurses and medical personnel to judge, but to treat with fairness and compassion. It is easy to look down on this patient for her chronic illnesses that affect her long-term health, but she needs help, and now may never be back to her pre-hospitalized state. The patient is anxious and has a history of mental health issues, and it truly tests you as a nurse to see her fighting the ventilator and being unable to sedate. It is shown just how hard nursing care can be, but in the end it is our job to give competent care and this will be carried out with all future patients. This patient has a long road ahead for recovery, and may still have lasting debilitating effects in the

I write on behalf of my patient, Phil Robins, who is a sixty-five-year-old male facing acute urinary retention. Phil Robins shows several medical symptoms, including an inability to urinate, severe pain and discomfort in the lower abdomen, and bloating of the lower abdomen. My patient has been previously diagnosed with benign prostatic hyperplasia which has been obstructing his urinary tract. Because of this, he frequently has to use a catheter to empty his bladder.

In many cases, ED nurses are the first health care provider to assess patients; therefore, it is essential that they have the clinical knowledge necessary to identify those at risk for sepsis, or exhibiting signs of early or even late sepsis. Quality improvement initiatives in the ED should include thorough educational efforts to ensure that nurses understand the sepsis condition in relation to the pathophysiology; the clinical triggers; its progression and implications; and the appropriate treatment that is best supported by evidence based research. Additional quality improvement measures should include the implementation of tools, processes, protocols/guidelines, and procedures required to assist nurses in the early identification and treatment of sepsis. Frontline nurses play an important role on the health care team, and perhaps are the key to reducing the morbidity and mortality of septic patients. The purpose of this quality initiative is to provide measures necessary to facilitate the frontline ED nurses in the early identification and treatment of sepsis. The clinical question for this scholarly project is as follows: “In the emergency department, will quality improvement initiatives, improve the frontline nurses’ early recognition and treatment of

The quicker the patient can come off of the ventilator the less of a risk for the patient. To wean a patient off the ventilator it is important to have a physician order and to do it slow to make sure the patient can maintain. Slowly stop the sedations and see if the patient can breathe over the ventilator. Breathing exercises are important with a patient who is intubated to be able to get off the vent sooner. Some reasons that a patient would need mechanical ventilation is respiratory distress, if a person can’t protect airway, overdose, or an injury to the

Upon investigating about the non-compliance with the DVT guidelines, this author found out that lack of knowledge, lack of monitoring and busy schedule of nursing personnel are the main reasons behind it. This author conducted a research on importance of DVT prevention and how to improve

Continuous Quality Improvement (CQI) is a strategic approach to providing the best healthcare possible. It is a preventative strategy that uses constant innovation to improve work processes and systems by reducing time-consuming, low-value activities. Time that was once spent on rework and crisis management is now spent on planning, coordination and control. As a nurse manager, one of my duties is to map out a sustainable plan that is efficient and effective enough to help my organization face the issues of performance and quality of care (Ballard, 2010). By implementing CQI, I will form a team that can help me to identify problems and challenges towards achieving effective and result oriented healthcare. This quality improvement team will be responsible for implementing, documenting, monitoring and evaluating the improvement plan. Responsibilities are then assigned to the members of this team. Then I will delineate scope of care and service, and one method of doing this is to identify the organizations key governance, managerial, clinical, and support functions. All departments and services should be made to contribute to this delineation of key functions. Using the scope of care and services as a basis, the ones that are important for ongoing monitoring shall be selected by those who are experts in the areas under consideration. Indicators which can be used to monitor care and services are identified and monitored by knowledgeable staff in the particular area. Threshold will be established for each indicator to determine when

Staff allergic to latex must inform their manager and be provided with latex free gloves

This project explores the evidence-based approach to improving the rates of ventilator associated pneumonia in intubated intensive care unit patients. Ventilator associated pneumonia is defined as the development of pneumonia in a mechanically ventilated and intubated patient within 48 hours before the onset of pneumonia as per the Center for Disease Control and Prevention. Ventilator associated pneumonia or VAP for short is the second most common nosocomial infection in the United States and the most common healthcare-associated infection of ventilated patients, affecting an estimated 28% (Halyard, 2015). The death rate of patients diagnosed with ventilator associated pneumonia is up to 33%(Halyard, 2015), and higher than the rate of death due to central line infections, sepsis and respiratory tract infections. Furthermore, for each case of ventilator associated pneumonia, the cost of care for each patient increases by $40,000 to $57,000(Sedwick, 2012) and they stay an estimated 4 to 6 days longer in the ICU (Halyard, 2015) as compared to intubated patients not infected with pneumonia. Ventilator associated pneumonia is one of the leading problems amongst intensive care units worldwide and the implementation of a VAP prophylaxis bundle protocol can improve the outcome for mechanically ventilated patients. Throughout this paper, three evidence-based research articles aimed at improving the outcome of ventilated patients are explored.

Furthermore, nurses have expressed concerns that open visitation exposes vulnerable, immunocompromised patients to an increased risk of infection.2,29 However, there is a limited amount of empirical evidence to support this claim.29 Moreover, in a prospective, observational study, examining the relationship between intensive care acquired infections and visitors, Malacarne et al found that there was no evidence of the pathogenic or colonized microorganisms on the visitors (n=90) of the patients (n=20) who tested

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.