ZAP VAP YVONNE SENTNER WAYNESBURG UNIVERSITY NUR589: EVIDENCE-BASED NURSING PRACTICE NANCY STYNCHULA, BSN, RN OCTOBER 6, 2010
INTRODUCTION Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn, 2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that Improper hand washing can result in cross contamination. With all the likely sources of VAP, hospitals and nurses must make every effort to prevent its spread. All of the articles reviewed for this paper states that education is the best way to zap vap! Doctors and nurses should encourage patients to get their pneumonia vaccination. Hand washing is also important for doctors, nurses and visitors. Nurses should give diligent mouth care every few hours and use chlorhexidine twice a day. They should suction the patient's endotube and mouth every two hours and as needed to prevent the pooling of secretions. Turning the patient every two hours and doing chest physiotherapy (chest percussion) can increase pulmonary drainage. A flutter valve can help break up secretions so the patient is able to cough them up easily. The head of bed should be elevated between 30 and 45 degrees to minimize the risk of reflux and aspiration of bacteria. Many studies suggest that interventions to reduce VAP should start with intubation and end with extubation. Many doctors feel that the interventions should start with all patients because they never know when a patient will need intubated. Prophylaxis should start at hospital admission. This paper will mainly discuss the importance of using chlorhexidine oral solution. Chlorhexidine is an antimicrobial that decreases the bacteria in the mouth. If the
