Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
prophylaxis, avoidance of unplanned extubation, and avoidance of
gastric over distention. Prevention of VAP is the focus applied to
critical care nurses utilizing evidenced based practice. Proper use of
these nursing interventions can facilitate an environment of optimal
wellness for the critically ill patient.
Aim of the study
This study investigated the benefits of nursing practice outcomes in
the prevention of ventilator associated pneumonia and
understanding how nursing interventions exemplify the importance
of evidenced based research in nursing practice.
Methodology including research design and sampling
Design: Quantitative: Descriptive, Longitudinal
Sampling was obtained from mechanically ventilated adult patients
within the Intensive Care Unit. Inclusion criteria included all
ethnicities, male and female, intubations originating in ICU,
operating room, acute care, and emergency department. Exclusion
criteria included preexisting pneumonia prior to intubation
confirmed on X-Ray.
Data collection started in 1998 and continues through 2007.
Analysis
Ventilator associated pneumonia was entirely eliminated in the
Intensive Care Unit during this descriptive, longitudinal study.
Nursing interventions that integrated oral care, hand washing, and
the “ventilator bundle,” which included: elevation of head of bed,
sedation vacation, peptic ulcer and deep vein thrombosis
prophylaxis, were major contributing factors to this outcome. These
interventions have continued to prevent VAP for two consecutive
years.
Also contributing to the study’s success were recommendations
implemented from Institute for Healthcare Improvement, Centers
for Disease Control, and extensive literature reviews.
Summary of key findings
From January 1998 until March 2005 there was an average of 38.4
VAP per 1,000 ventilator days. Nursing interventions that integrated
oral care, hand washing, and the “ventilator bundle,” which
included: elevation of head of bed, sedation vacation, peptic ulcer
and deep vein thrombosis prophylaxis. As a result of these
interventions, which have continued to prevent VAP for more than 2
consecutive years, there has been no documented ventilator
assisted pneumonia from April 2005 until July 2007.
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