Evidence-based Practice in Nursing Ventilator-Associated Pneumonia

Evidence-based Practice in Nursing Ventilator-Associated Pneumonia Ventilator-associated pneumonia, a nosocomial infection that can occur during prolonged periods of mechanical ventilation, is a frequent health-care-associated infection. According to reports, ventilator-associated pneumonia affects 10% to 20% of ventilator-dependent patients in the United States each year. Evidence-based standards have transformed how nursing procedures are managed in order to tackle a preventable problem. In 2001, the Institute for Healthcare Improvement created the "ventilator bundle" approach to lower the incidence of ventilator-associated pneumonia. This includes the following: Elevating the bed's head by 30 to 45 degrees. This reduces gastric aspiration and aids in secretion outflow. Performing a sedation interruption on a daily basis. Continuous sedation can result in over-sedation, which increases the risk of ventilator-associated pneumonia. Keeping scheduled ventilator circuit changes to a minimum. Frequent circuit alterations raise the risk of ventilator-associated pneumonia. Since the guidelines were published, many ICUs have implemented the ventilator bundle. According to the Institute for Healthcare reduction, institutions that followed the bundle guidelines saw significant reduction in ventilator-associated pneumonia rates, with "some even reaching zero by taking a comprehensive and multidisciplinary approach to ventilator care." COPD Patients and Oxygen Therapy It was formerly thought that giving COPD patients oxygen could cause major health problems such as hypercarbia and acidosis. Some even thought it could result in death. Nonetheless, providing oxygen to COPD patients to prevent hypoxia and organ failure is now an important evidence-based protocol. Why is oxygen treatment now considered the gold standard of care? Because reliable research has shown that oxygen therapy can improve the quality of life of COPD patients. It has been demonstrated to make COPD patients feel better and encourage them to be more active. Another groundbreaking study discovered that long-term oxygen therapy could potentially extend the lives of COPD patients. Adolescents Receiving Inpatient Care Nurses now know that daily bathing with 2% chlorhexidine gluconate benefits children in inpatient care due to evidence-based studies. A study conducted by Cincinnati Children's Hospital discovered that bathing with this solution on a daily basis lowered the chance of a bloodstream infection. In fact, the study goes on to show that 2% chlorhexidine gluconate bathing every other day instead of daily soap and water bathing reduced the risk of infection by as much as 45%. Avoiding Intestinal Blockage Following Abdominal Surgery Patients undergoing abdominal surgery frequently have postoperative ileus (POI), which causes severe pain and suffering. A study led by a group of oncology nurses discovered a simple technique to avoid POI: chewing gum. Research conducted found that gum-chewing patients improved more quickly, had better overall outcomes, and even had shorter hospital stays. These particular nurses found that of 159 patients who underwent abdominal surgery during a specific timeframe,15 patients developed POI. Five of the patients had chewed gum, while the other ten had not. A report published by the International Journal of Clinical and Experimental Medicine reported another study that showed only 27% of gum-chewing patients developed POI as compared to 48% of patients in the control group who did not. As a result, "chewing gum has emerged as a novel and simple strategy for promoting the recovery of gastrointestinal function." Stress Reduction in Nurses Evidence-informed protocols extend well beyond just the care of patients. They apply to the care of nurses. It’s well known that nursing is an occupation that comes with high levels of stress and anxiety. In some cases the stress of the job even leads to depression or burnout, especially for those working in areas like emergency rooms and oncology units. One proven practice is Mindfulness-Based Stress Reduction (MBSR), which seeks to reduce “psychological distress among nurses.” According to a National Library of Medicine article, studies found MBSR reduces stress, anxiety, and depression among nurses. Furthermore, studies revealed the protocol leads to increased job satisfaction and less burnout. In one particular study, all 36 nurse participants showed improved general health, decreased stress, and decreased work burnout, and these changes were sustained at least four months later.

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