Ventilator-Associated Pneumonia and Oral Bacteria
Nelya Sirotinskiy and Danielle Davidson
DHYG 221
Columbia Basin College
February 9th, 2017
Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infection associated with increased morbidity and mortality. It is recognized that 36-60% of all health associated infection-related deaths are attributable to VAP (Gupta et al, 2016). Ventilator-associated pneumonia is a lung infection that develops in a person who is on a ventilator for more than 48 hours, usually patients in the intensive care unit (ICU) at a hospital. A ventilator is a machine that is used to help a patient breathe by giving oxygen through a tube placed in a patient’s mouth or nose, or
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Registered dental hygienists working alongside with the nurses would significantly decrease the prevalence of this hospital infection. Another opportunity for the registered dental hygienist would be to train and provide educational classes and continuing education programs to health care providers. Nursing staff have limited knowledge regarding oral health and the dental needs of patients. Therefore, health care workers responsible with treating patients on ventilators need to be educated on proper toothbrushing techniques, dental plaque identification, use of fluoride varnishes, and any indicators of dental disease. Routine meetings with the unit nursing staff or respiratory therapist to review patient outcomes will help the hygienist adjust and revise the protocol as needed. Interprofessional collaboration provides an excellent opportunity to develop protocols that are beneficial to the patient and to the health care professionals providing the oral …show more content…
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Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
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Epidemiology of VAP Hunter, Annadurai and Rothwell defines ventialtor-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal or trascheotomy tube. It is commonly classified as either early onset (occurring within 96 hours of start of mechanical ventilation) or late onset (>96 hours after start of mechanical ventilation. A ventilator is a machine that is used to help a patient breathe by giving oxygen through an endotracheal tube, which is a tube placed in a patient’s mouth or nose, or through a tracheostomy, which is a surgical opening created trough the trachea in front of the neck. Infection may occur if bacteria or virus enters the tube into the lungs or airways by manual manipulation of the ventilator tubing. Ventilator-associated pneumonia accounts for 80% of hospital-acquired pneumonia, 8-28% of incubate... ...
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
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Preventing the spread of infection has been the most important key component to having good health care. As a Dental Assistant, reducing the risk of infection for patients is of the upmost importance across the dental field. There are a variety of responsibilities and procedures needed to be done before and after assisting every patient. First and foremost, personal hygiene in the dental clinic is very important, sterilization of instruments, and cleaning/replacing operatory units are also critical action to take during an infectious procedure.
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
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Ventilator Associated Pneumonia (VAP) is one of the most common infections that are acquired through many ways and is particularly found in the Intensive Care Unit (ICU). One of the primary risk factors that lead to the development of VAP is the availability of an endotracheal tube. In many cases, the intubation process takes place in the emergency room (ER), pre-hospital, and in the operation room. In the current world, VAP has been directly associated with the increased costs and prolonged hospital stay. Numerous evidence-based guidelines (protocols and procedures) have been put in place to minimize the occurrence of VAP and reduce the mortality rate of the patients. Preventive measures have also been
Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung infection that occurs in a person who has been on a ventilator.... ... middle of paper ... ...
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Pneumonia Pneumonia is a serious infection or inflammation of your lungs. There are two main types Pneumonia one of these is bacterial pneumonia. This can attack anyone from infants to the very old. People who are alcoholics, debilitated, post-operative patients, people with respiratory diseases or viral infections and people who have weakened immune systems are at greater risk. Pneumonia bacteria are present in some healthy throats.
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