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Reducing the incidence of ventilator-associated pneumonia with selected positional strategies

Ventilator-associated pneumonia (VAP) has been attributed with lengthening patients' stay in the intensive care unit (ICU), is the leading cause of death among nosocomial infections, and leads to increased hospital cost. Various positional strategies in the prevention of VAP include head of bed (HOB) elevation, continuous lateral rotation therapy (CLRT), and kinetic bed therapy. However, poor compliance rates in critical care units have been reported. Mechanically ventilated patients develop nosocomial pneumonia at a rate 6 to 21 times greater than non-ventilated hospitalized patients. A HOB elevation of 30' to 45' and the turning of patients every two hours are two commonly accepted guidelines used to prevent respiratory compilations by facilitating the clearance of pulmonary secretions. Both HOB elevation and CLRT were explored as interventions that could be implemented to reduce the incidence of VAP. It is difficult to attribute reduced VAP rates to either modality alone. However, when HOB elevation and CLRT are utilized in concert with other modalities, clinically significant benefits become readily apparent. Implementation of both improves clinical outcomes. These modalities should not be considered as individual strategies to reduce VAP, but as part of a comprehensive approach to reduce the incidence of VAP and improve patient outcomes.

Identiferoai:union.ndltd.org:ucf.edu/oai:stars.library.ucf.edu:honorstheses1990-2015-2059
Date01 January 2010
CreatorsTucker, Brandon Raye
PublisherSTARS
Source SetsUniversity of Central Florida
LanguageEnglish
Detected LanguageEnglish
Typetext
SourceHIM 1990-2015

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