Question
Discuss the hospital-associated infection of Ventilator-associated pneumonia (VAP). Discuss interventions/resources and system approaches that should be implemented to reduce and/or eliminate the occurrence. Consider what the barriers to success might be and how to address.
Use these as a reference:
https://www.cdc.gov/hai/vap/vap.html
https://www.cdc.gov/hai/prevent/prevention.html
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm
Wachter, R.M. (2008). Understanding patient safety, second edition. New York: McGraw Hill.
Answer
According to research, pneumonia affects 27% of all the critically ill patients that have been admitted into the ICU, making it one of the most common nosocomial infection (Bauer et al., 2000). Ventilator-associated pneumonia (VAP) accounts for 86% of all nosocomial infections among the critically ill (Lerma et al., 2014). Patients admitted to the intensive care unit (ICU) are often at the risk of succumbing to their illness or dying from other secondary infections. Over time, a lot of time, money and energy have been put into reducing the rates of VAP-related deaths in the ICU. This paper will discuss VAP, interventions that will help to reduce or eliminate the disease as well as any barriers to success and how they can be addressed.
VAP is a hospital-associated lung infection that develops in a critically ill patient that has been put on a ventilator for at least 48 hours (American Thoracic Society, 2005). All ICU patients need help breathing either through their nose or mouth. This is achieved with the use of a ventilator in most cases. While the ventilators are used to help prolong the life of the patient, they may cause their eventual death if certain germs make their way through the tube and into the lungs of the patient in question. There are several causes of VAP depending on who administered the primary care and how it was administered. Many difficult tests are required before diagnosing a patient with VAP (Baltimore, 2003).
As mentioned earlier, there are a number of factors that lead to VAP. Consequently, one important intervention that is necessary to reduce or eliminate its occurrence is that of educating all healthcare providers on its mode of transmission, cause, risk factors, prevention, diagnosis, and treatment (Cason et al., 2007). The more educated the healthcare staff members are, the easier it becomes to avoid doing anything that will jeopardize the health and full recovery of the critically ill patient. Also, training these professionals on the proper care of the ventilating machines as well as other equipment that come into direct contact with the lungs is essential (Lerma et al., 2014).
While this may be a simple intervention, lack of funds may present a problem when it comes to its implementation. Every healthcare organization has its set priorities at any given time. For some institutions, managing and preventing VAP may not top the list. In such cases, it becomes tough to provide enough funds needed for the training and education of all the ICU healthcare personnel. To overcome this barrier, it is necessary for the management of VAP to be a mandatory requirement of every healthcare facility. Doing this will make healthcare personnel see the importance of eliminating the tragedy that is VAP altogether. In turn, the healthcare facility will set aside enough money to fund the educational programs and training sessions.
VAP is the leading cause of death among the critically ill patients in the ICU. It is enough that the patients enter the ICU hanging on to their lives. They should not have to face an added risk of acquiring any hospital-associated infections. It is therefore important that the healthcare personnel receive enough training on how to clean ICU equipment, administer drugs and take care of the patients in general. Creating separate funds for such training programs will reduce all recorded cases of VAP. This will in turn help eliminate VAP-related deaths.
References
American Thoracic Society, & Infectious Diseases Society of America. (2005). Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 171, 388-416.
Baltimore, R. S. (2003). The difficulty of diagnosing ventilator-associated pneumonia. Pediatrics, 112(6), 1420-1421.
Bauer, T. T., Ferrer, R., Angrill, J., Schultze-Werninghaus, G., & Torres, A. (2000, December). Ventilator-associated pneumonia: incidence, risk factors, and microbiology. In Seminars in respiratory infections (Vol. 15, No. 4, pp. 272-279).
Cason, C. L., Tyner, T., Saunders, S., & Broome, L. (2007). Nurses’ implementation of guidelines for ventilator-associated pneumonia from the Centers for Disease Control and Prevention. American journal of critical care, 16(1), 28-37.
Lerma, F. Á., García, M. S., Lorente, L., Gordo, F., Añón, J. M., Álvarez, J., … & Jam, R. (2014). Guidelines for the prevention of ventilator-associated pneumonia and their implementation. The Spanish “Zero-VAP” bundle. Medicina Intensiva, 38(4), 226-236.