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Ventilator-associated pneumonia: Why are we not at zero?

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Ventilator-associated pneumonia: Why are we not at zero?

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By Davina Petrakos
Sentara College of Health Sciences

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Despite evidence-based clinical practice guidelines being available for over a decade, ventilator-associated pneumonia (VAP) continues to be one of the leading nosocomial infections among mechanically ventilated (MV) patients

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Collaboration with interdisciplinary team

Patient advocate

Educator

Effective communicator

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Challenges and barriers must be identified and addressed

Gain healthcare provider's perspective via focus groups and surveys

Educational in-services

Monitor compliance with weekly feedback to the unit

Interdisciplinary rounds

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Challenges and barriers nurses face in preventing VAP

Understaffed units

Oral care viewed as a comfort measure than a necessity

Time constraints

Limited access to mouth due to endotracheal tube

Nurses' attitude toward guidelines

Lack of knowledge

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How can the nurse help with VAP reduction

Ensuring autonomous nursing interventions have been implemented

Ensuring medications have been ordered by the physician

Ensure a daily assessment of readiness to extubate and sedative interruption has been attempted

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Nurse's current role in reducing VAP

Head-of-bed elevation between 30 and 45 degree

Brushing the patient’s teeth, gums, and tongue twice a day

Providing moisture to the lips every 2 to 4 hours

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Lack of awareness of institutional guidelines regarding oral care

Time is a limiting factor in implementing VAP interventions

Educational in-services decreased VAP rates

Significant association between nurses’ perceptions regarding stafﬁng and resource adequacy and nosocomial infection rate