Ventilator-associated pneumonia (VAP) is among the most dangerous infections affecting patients in intensive care units (ICU) around the world. Almost half of the patients in the ICU, who undergo intubation and mechanical ventilation for more than 48 hours, develop ventilator-associated pneumonia. About forty-eight percent of patients suffering from VAP die. VAP has higher rates of mortality rates in comparison with other hospital-related infections around the world. The condition raises the cost of patient care in hospitals, which is detrimental to the healthcare industry. Additionally, the condition extends the patient’s length of stay at the hospital, which further complicates the quality of health care (Sedwick et al., 2012). For this reason, nurses should employ the use of evidence-based practices in caring for mechanically ventilated patients to reduce the risk of VAP. Contaminated secretion together with the aerodigestive tract disease increases mortality rates among people suffering from VAP. The condition is rather costly for both the health facility and the patients. Therefore, there is a need for the ministry of health to invest in evidence-based practice in handling VAP.
Possible Remedies to VAP
The center for disease control and Prevention (CDC) has come up with various strategies that help reduce the risks of VAP. Ventilator-associated pneumonia has many risk factors. Each of these factors can be used to reduce or eliminate VAP infections. The use of the evidence-based practice in nursing has proven successful over the last few years. Using evidence-based practice is in handling the risks of VAP infections among ventilated patients in the ICU is, therefore, a wise course of action. The CDC’s VAP intervention bundle contains four interventions that can help reduce VAP infections in ICU patients. Lifting of the heads of the beds is the most common intervention used in the ICU (Par, Badovinac, & Plancak, 2014). However, research indicates that regardless of the positive results arising from the use of mouth care to prevent VAP, hospitals are yet to embrace the intervention in ICU health care.
Microbes increase the chances of VAP infections. People in ICU cannot undergo normal mouth and teeth cleaning for obvious reasons. As a result, the oral flora of the mouth changes considerably within 48 hours of ventilation. Additionally, dental plaque provides an ideal environment for pathogens to thrive in the mouth, thus increasing the chances of VAP infections. For this reason, it is advisable for nurses to employ the use evidence-based mouth care practices in reducing VAP infections. The use of histamine increases the PH level of the mouth, thus reducing the chances of airway blockages (Atay & Karabacak, 2014). In addition, oral application of antiseptics and antibiotics help reduce the multiplication of microbes, thus reducing VAP infections. Carrying out often mouth care also plays an important role in the prevention of VAP among ventilated patients. Most of the normal body functions stop working when a person goes to ICU. The body’s inability to function normally makes it possible for microorganisms to thrive in the mouth. For this reason, nurses should use chlorhexidine in brushing the patients’ teeth for better results. In addition, using a tooth sponge to wipe the patient’s mouth ten times a day reduces the chances of VAP infection in patients.
Comparison with Other Practices
The debate on which mouth care mechanism to use in handling patients undergoing ventilation in the intensive care unit is a rather heated one. However, different mechanisms have different impacts on the health of a patient, thus making it easy to come up with the ideal solution. Instead of using oral chlorhexidine, some people might prefer to use povidone-iodine. The agent is ideal for drying up the mucous, which prevents VAP infections. However, unlike chlorhexidine, iodine dries the mouth too much making it hard to breathe, which may further cause air pipe fractures. As a result, iodine cannot be used for a long time, thus reducing its effectiveness in mouth care. On the other hand, a nurse can choose to use a normal toothbrush rather than a sponge to clean the patient’s mouth (Balamuruga, Kanimozhi & Kumari, 2012). The use of a normal toothbrush limits the cleaning process. Failure to clean these parts of the mouth raises chances of plaque development. Other traditional mouth cleaning techniques employ the use of normal tap water rather than the chemical agents to clean the mouth. As much as water is useful in keeping the mouth wet, tap water has many microorganisms that increase the chance of VAP infections. In general, while the use of the new mouth care processes reduces VAP risks by 80%, the use of traditional approaches reduces the risks by 25%
Significance and the Outcome of the Interventions
VAP is a preventable condition yet a major concern in healthcare today. The government intends to withdraw its funding on VAP infections. People are quite knowledgeable today, and there is plenty of information to help both patients and practitioners to uphold healthy practices. The proposal puts hospitals in a precarious situation because they will have to incur all the costs arising from VAP infections. Research indicates that VAP is the most costly condition to handle among the hospital-related infections. For this reason, the vitality of the use of mouth care practices to reduce VAP infections in the current world is indisputable (Snyders, Khondowe & Bell, 2011).
The use of mouth care reduces VAP infections considerably. The first and the most important outcome of this course of action is a reduction in VAP related mortality rates. The condition is a major cause of death for people in the ICU. Secondly, the intervention will help reduce the costs that hospital experience in the treatment of VAP. The third outcome of the intervention is the improvement and betterment of quality care in ICU departments. Fourthly, the intervention provides an ideal avenue for Professional Cooperation as nurses and other therapists work together to improve the health condition of the ICU patients.
In conclusion, VAP is a dangerous condition, mostly affecting patients undergoing mechanical ventilation in ICU. Health personnel have come up with various ways to reduce VAP infections, some of which have proven successful. One of the most effective techniques is the use of ventilator bundles coined by the CDC. The bundle has various techniques that nurses can use in handling ventilated patients. However, the use of mouth care to reduce VAP is rarely practiced (Sedwick et al., 2012). Evidence-based research indicates that mouth care of ventilated patients has a significant impact on VAP; therefore, nurses must employ this technique in ICU patient care.
Atay, S. & Karabacak, U. (2014). Oral care in patients on mechanical ventilation in the intensive care unit: a literature review. International Journal of research in medical science, 2 (3), 8222-829.
Balamuruga, E., Kanimozhi, A. & Kumari, G. (2012). Effectiveness of chlorhexidine oral decontamination in reducing the incidence of ventilator-associated pneumonia: A Meta-analysis. BJMP, 5 (1), 1-5.
Par, M., Badovinac, A. & Plancak, D. (2014). Oral hygiene is an important factor for prevention of ventilator-associated pneumonia. Acta Clin Croat, 53 (1), 72-79.
Sedwick, M., Lance-Smith, M., Reeder, S. & Nardi, J. (2012). Using evidence-based practice to prevent ventilator-associated pneumonia. Critical care nurse, 32 (4), 41-53.
Snyders, O., Khondowe, O. & Bell, J. (2011). Oral chlorhexidine in the prevention of ventilator-associated pneumonia in critically ill adults in the ICU: a systematic review. SAJCC, 27 (2), 48-56.