Effectiveness of a PRN Approach to Lowering the Rate of Ventilator-Associated Pneumonia among Patients in an ICU/CCU

2.50
Hdl Handle:
http://hdl.handle.net/10755/163442
Category:
Abstract
Type:
Presentation
Title:
Effectiveness of a PRN Approach to Lowering the Rate of Ventilator-Associated Pneumonia among Patients in an ICU/CCU
Author(s):
Hoerst, Barbara J.; Fox, Mary Agnes; Ragasa, Florecita
Author Details:
Barbara J. Hoerst, PhD, RN, Assistant Professor, Lasalle University School of Nursing, Philadelphia, Pennsylvania, USA, email: hoerst@lasalle.edu; Mary Agnes Fox, MSN, RN; Florecita Ragasa, CCRN, RN
Abstract:
Purpose: The purpose of this study is to evaluate the effectiveness of a PRN (pharmacy, respiratory therapy, and nursing) approach to lowering the rates of ventilator-associated pneumonia in an ICU/CCU. Theoretical Framework: The Quality Health Outcomes Model guides this study. This model recognizes the effect of an intervention on an outcome is mediated by a relationship between the patient (e.g., comorbidities) and the system (e.g., use of technology). Methods (Design, Sample, Setting, Measures, Analysis): This study uses a multi-stage PRN approach. The outcome is the monthly rate of VAP in the ICU/CCU. The independent variables reflect timing and priorities of the three disciplines. Step 1: Nursing - January 2005; an oral care protocol using a specifically designed suction toothbrush, oral antiseptic rinse, and mouth moisturizer. Swabbing of the mouth will be done every 2 hours and brushing of the teeth will be done twice a day at 12-hour intervals. Step 2: Respiratory therapy - July 2005; 2 processes were put into place. The first was the use of sterile caps for all tubing ends and for Ambu bags during disconnections. The second process introduced endotracheal tubes with continuous subglottal suction. Step 3: Pharmacy - projected start date of January 2006. The pharmacy has developed a protocol for a sedation holiday that will help to assess readiness for extubation. Results: The data in the first 6 months demonstrated a consistent decline in the VAP rate among patients in the ICU/CCU from a high rate of 23.8 to rates of 2.5 and 3.4. Data in the few months have fluctuated somewhat; however, rates are remaining far below pre-invention rates. Conclusions and Implications: Multidisciplinary efforts are effective in breaking the chain of infection responsible for VAP rates among patients in ICU/CCU. Because of the vulnerability of patients in ICU/CCU to infection, the actions of various members of the healthcare team are vital in preventing this serious complication.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
18th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Cherry Hill, New Jersey
Description:
�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jersey
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEffectiveness of a PRN Approach to Lowering the Rate of Ventilator-Associated Pneumonia among Patients in an ICU/CCUen_GB
dc.contributor.authorHoerst, Barbara J.en_US
dc.contributor.authorFox, Mary Agnesen_US
dc.contributor.authorRagasa, Florecitaen_US
dc.author.detailsBarbara J. Hoerst, PhD, RN, Assistant Professor, Lasalle University School of Nursing, Philadelphia, Pennsylvania, USA, email: hoerst@lasalle.edu; Mary Agnes Fox, MSN, RN; Florecita Ragasa, CCRN, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/163442-
dc.description.abstractPurpose: The purpose of this study is to evaluate the effectiveness of a PRN (pharmacy, respiratory therapy, and nursing) approach to lowering the rates of ventilator-associated pneumonia in an ICU/CCU. Theoretical Framework: The Quality Health Outcomes Model guides this study. This model recognizes the effect of an intervention on an outcome is mediated by a relationship between the patient (e.g., comorbidities) and the system (e.g., use of technology). Methods (Design, Sample, Setting, Measures, Analysis): This study uses a multi-stage PRN approach. The outcome is the monthly rate of VAP in the ICU/CCU. The independent variables reflect timing and priorities of the three disciplines. Step 1: Nursing - January 2005; an oral care protocol using a specifically designed suction toothbrush, oral antiseptic rinse, and mouth moisturizer. Swabbing of the mouth will be done every 2 hours and brushing of the teeth will be done twice a day at 12-hour intervals. Step 2: Respiratory therapy - July 2005; 2 processes were put into place. The first was the use of sterile caps for all tubing ends and for Ambu bags during disconnections. The second process introduced endotracheal tubes with continuous subglottal suction. Step 3: Pharmacy - projected start date of January 2006. The pharmacy has developed a protocol for a sedation holiday that will help to assess readiness for extubation. Results: The data in the first 6 months demonstrated a consistent decline in the VAP rate among patients in the ICU/CCU from a high rate of 23.8 to rates of 2.5 and 3.4. Data in the few months have fluctuated somewhat; however, rates are remaining far below pre-invention rates. Conclusions and Implications: Multidisciplinary efforts are effective in breaking the chain of infection responsible for VAP rates among patients in ICU/CCU. Because of the vulnerability of patients in ICU/CCU to infection, the actions of various members of the healthcare team are vital in preventing this serious complication.en_GB
dc.date.available2011-10-27T11:07:39Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:07:39Z-
dc.conference.date2006en_US
dc.conference.name18th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationCherry Hill, New Jerseyen_US
dc.description�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jerseyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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