2.50
Hdl Handle:
http://hdl.handle.net/10755/203182
Type:
Presentation
Title:
Zap the VAP
Abstract:
(Summer Institute) Problem: Ventilator-associated pneumonia (VAP) is a nosocomial infection that is preventable. Based on the formula (number of VAPs divided by 1000) developed by NHSN, the national standard is 2.9. Our December, 2010 rate was 11. Evidence: Evidence suggests that frequent oral care and the use of chlorhexidine gluconate (CHG) oral antiseptic every 12 hours can prevent VAP (Whip & Napolitano, 2009; IHI, 2010). Strategy: Provided education to MSICU staff on performing oral care with and without CHG 0.12%. 1-Staff used CHG 0.12% oral rinse every 12 hours in intubated patients. 2- Staff performed oral care every 4 hours. 3- Staff elevated patient's HOB 30-45 degrees. 4- Sedation vacation was implemented for possible extubation. 5- Elevate head of bed 30-45 degrees. Practice Change: The current standard of practice was to perform oral hygiene every shift and prn on intubated patients without the use of CHG 0.12%. Evaluation: The number of patients acquiring VAP after receiving oral hygiene with CHG 0.12% decreased. Results: YAP was prevented. Our current rate is 0. Recommendations: Meticulous oral hygiene every 4 hours and oral care with CHG 0.12% oral rinse every 12 hours. Lessons Learned: Intubated patients require frequent meticulous oral hygiene to prevent VAP. Maintaining the HOB between 30 and 45 degrees assists with removal of secretions. Sedation vacation assisted with extubation. Bibliography: Goss, L.K., Coty, M.B., & Meyers, J.A. (2010). A review of documented oral care practices in an intensive care unit. Clinical Nursing Research, 1-16. Panchabhai, T.S., Dangayach, N.S., Krishnan, A., Kothari, V.M., & Kamad, D.R. (2009). Oropharyngeal cleaning with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: An open­ label randomized trial with 0.1% potassium permanganate as control. Chest, 135, 1150-1156. Whip, C. & Napolitano, L. (2009). Bundles to prevent ventilator-associated pneumonia: how valuable are they? Current Opinion in Infectious Diseases, 22, 159-166. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Zap; VAP
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleZap the VAPen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203182-
dc.description.abstract(Summer Institute) Problem: Ventilator-associated pneumonia (VAP) is a nosocomial infection that is preventable. Based on the formula (number of VAPs divided by 1000) developed by NHSN, the national standard is 2.9. Our December, 2010 rate was 11. Evidence: Evidence suggests that frequent oral care and the use of chlorhexidine gluconate (CHG) oral antiseptic every 12 hours can prevent VAP (Whip & Napolitano, 2009; IHI, 2010). Strategy: Provided education to MSICU staff on performing oral care with and without CHG 0.12%. 1-Staff used CHG 0.12% oral rinse every 12 hours in intubated patients. 2- Staff performed oral care every 4 hours. 3- Staff elevated patient's HOB 30-45 degrees. 4- Sedation vacation was implemented for possible extubation. 5- Elevate head of bed 30-45 degrees. Practice Change: The current standard of practice was to perform oral hygiene every shift and prn on intubated patients without the use of CHG 0.12%. Evaluation: The number of patients acquiring VAP after receiving oral hygiene with CHG 0.12% decreased. Results: YAP was prevented. Our current rate is 0. Recommendations: Meticulous oral hygiene every 4 hours and oral care with CHG 0.12% oral rinse every 12 hours. Lessons Learned: Intubated patients require frequent meticulous oral hygiene to prevent VAP. Maintaining the HOB between 30 and 45 degrees assists with removal of secretions. Sedation vacation assisted with extubation. Bibliography: Goss, L.K., Coty, M.B., & Meyers, J.A. (2010). A review of documented oral care practices in an intensive care unit. Clinical Nursing Research, 1-16. Panchabhai, T.S., Dangayach, N.S., Krishnan, A., Kothari, V.M., & Kamad, D.R. (2009). Oropharyngeal cleaning with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: An open­ label randomized trial with 0.1% potassium permanganate as control. Chest, 135, 1150-1156. Whip, C. & Napolitano, L. (2009). Bundles to prevent ventilator-associated pneumonia: how valuable are they? Current Opinion in Infectious Diseases, 22, 159-166. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectZapen_GB
dc.subjectVAPen_GB
dc.date.available2012-01-16T11:01:56Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:01:56Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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