Graduation Year

2024

Document Type

Senior Thesis

Degree

Bachelor of Science in Nursing

Primary Major

Nursing

Thesis Advisor

Kendra Hoepper DNP, APRN. PNP

Abstract

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the pathology of VAP, protocol compliance, to reducing VAP rates and identifying weak points in current hospital practices. Method: An observational longitudinal intervention study will be conducted in an adult ICU setting. The initial phase utilizes an uncontrolled group, setting a baseline. Followed by the subsequent phase, where participants become a controlled group, after the introduction of ventilator bundles. The data will be collected using, in person observation of nurse adherence and skill competency, along with providing educational classes on a bi-weekly basis. Concluding with a monthly questionnaire, that compares and reevaluates nurses' knowledge of preventative measures and treatment for VAP patients. Results: Preliminary findings suggest when conducting a continuous education program and implementing a “Ventilator Bundle” approach, VAP rates drastically drop. Conclusion: Each bundle included five main interventions (elevation of HOB 35°-45°, daily “sedation vacation & assessment of readiness to extubate, PUD prophylaxis DVT prophylaxis, and daily oral care with chlorhexidine). All interventions are pulled from the IHI bundle, indicating potential for making this the gold standard protocol. Overall proper adherence by all team members and ventilator education should be required by all ICUs.

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