Paper Sample on Ventilator-Associated Pneumonia:A Common Respiratory Infection

Introduction

Various infections affect the lungs of human beings and leave the victims in chronic conditions if not treated early enough. Exchanging air in the body between the lungs and the atmosphere requires adequate ventilation between the body organs to ensure that carbon dioxide in the alveoli of the lungs is successfully released into the atmosphere. Ventilators act as respiratory aids in human being respiratory systems. Ventilator-associated pneumonia is a type of infection that affects the lungs. It majorly occurs in people who are using mechanical ventilation breathing machines in hospitals. Typically, ventilator-associated pneumonia majorly affects critically ill persons, especially in intensive care units, because their bodies cannot fight various infections, making them prone to any infectious disease (Su et al., 2019). In many cases, ventilator-associated pneumonia is seen to cause increased illness and death if not diagnosed early enough. There are various propositions to use non-pharmacologic interventions to curb the critical conditions of ventilator-associated infections through research in large clinical trials and others in some pre-clinical stage.

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Background Information

Historically, Ventilator-associated pneumonia develops 48 hours or longer, especially after mechanical ventilation is given through an endotracheal tube or tracheostomy to patients in critical conditions. Ventilator-associated pneumonia occurs due to the lower respiratory tract and lung parenchyma invasion by a group of microorganisms (Timsit et al., 2017). It occurs due to intubation, which in most cases, the composition of the trachea in the breathing system and the integrity found in the lower part of the oropharynx, which functions towards allowing both the oral and other various gastric secretions which are always entering the lower airways in the breathing canal (Timsit et al., 2017).

There is dire need to prevent the spread of ventilator-associated pneumonia. It causes the nursing profession tiredness and fatigue since patients with these conditions need close administration from the nurses (Su et al., 2019). Also, there should be changes on how patients in the intensive care unit get health support, especially when it comes to breathing. Those under mechanical backing, in most cases, contract pneumonia due to the frequent use of ventilators. Health practitioners ought to find ways to boost the respiration process of various patients in critical conditions. Using non-pharmacological interventions will serve a great deal in ensuring that the rate of ventilator-associated pneumonia is under control.

Literature Review

Ventilator-associated pneumonia is the most frequent and dangerous infection acquired by a patient under mechanical support in the intensive care unit in health institutions. It has an infection incidence that ranges from a rate of 6 to 52% (Yilmaz et al., 2016). In various studies, it is evident that most critically ill patients are at high risk for contracting such respiratory infections. Ventilator-associated pneumonia continues to be a major cause of movement in search of a cure, an increase in death rate, and the addition of financial burden to patients fighting for lives in the intensive care unit. In the past years, there has been a significant advance in the understanding of ventilator-associated pneumonia.

National Healthcare Safety Network reports provide that the median ventilator-associated inconsistency in pneumonia rates are recorded in each intensive care unit and falls between 0.7 and 8.3 (Su et al., 2019). According to Su et al., (2019), an incidence of VAP of 15 was reported in France and 35 in Germany. Similar studies recorded a percentile of 18.4 for every ventilator day in various developing countries. In most of the studies according to Su et al., (2019), the incidence of VAP in the reviews and the rate of ventilator use in developed countries was approximately 4.5 times higher as compared to developing countries (Su et al., 2019).

Also, a substantial number of studies has investigated ventilator-associated pneumonia risk factors and development. Some of the factors include age, immunosuppressive and chronic conditions, respiratory failure, tracheotomy, abdominal, thoracic surgery, previous intake of antibiotics for a long time, enteral nutrition, and, intensive care hospitalization among others (Yilmaz et al., 2016). Further research provides that prevention measures against ventilator-associated pneumonia ought to start before the intubation procedure and sustained until the final stages.

The prevention measures should, therefore, be cost-effective, evidence-based, and easy to use since it is quite possible to lower nosocomial infections by 30 % by implementing strategic infection control programs (Su et al., 2019). Various studies have reported that failure of health workers is related to the increased level of VAP, whose prevention measures have not been widely embraced or put into practice. Additionally, a study conducted in Canada and France found that compliance with guidelines was quite low in the two nations. Furthermore, in a similar study in Europe, following the established instructions by the nursing staff and other healthcare providers was only 37% (Timsit et al., 2017).

Proposal

Various institutions should put in place guidelines that will function to help curb the ever-increasing rate of ventilator-associated infections through the use of adequately effective non-pharmacological interventions. They should initiate measures that avert the application of noninvasive ventilation to prevent endotracheal intubation. Besides, they should uphold using catheters that are coated with silver nitrate, which permits subglottic secretion drainage. It will, therefore, bolster the application of protocols which assesses the potential of daily sedation interruption while elevating the head of the bed, as well as offering oral care with chlorhexidine. Nonetheless, endotracheal intubation is the main risk for ventilator-associated pneumonia respiration using an endotracheal tube, especially when put in a horizontal position. Therefore, reducing intubation time is a non-pharmacological intervention that, through a daily sedation vacation in spontaneous breathing trials, acts as a reliable preventive measure. By positioning patients with the angle of an elevated bed, this functions to help reduce aspiration and clinically confirmed ventilation associated infections.

Another intervention is avoiding endotracheal tube cuff deflation, which helps prevent pulmonary diseases related to ventilation (Yilmaz et al., 2016). For s successful implementations of these interventions, there should be a close relationship between medical practitioners and the patients to know which position and angle they feel more comfortable with when on the hospital beds. Medical personnel in intensive care units should learn how to adjust the aspect in which patients lie on while administering treatment. Endotracheal tubes should be deflation-free to ensure that patients get the utmost care and prevent further spread of ventilator-associated infections (Torres et al., 2017).

Avoiding endotracheal tube cuff deflation is a combative measure for VAP since the infection is commonly nosocomial in the intensive care unit. Reports provide that the rate of transmission in most care units records at 1-3 per cent per day (Bassetti et al., 2016). The problem proceeds after the mechanical ventilator are initiated. It in turns precedes the growing incidence of VAP which also develops the automatic ventilator time. Similarly, there exists a wide difference in ventilator-associated pneumonia incidence that ranges between 5% and 7% of VAP related antibiotics (Bassetti et al., 2016). However, the invention may require high costs for hospitals, along with advanced technology in the hospital. This has therefore facilitated deaths related to such incidences due to expensive interventions or a complicated bundle component that primarily builds on a simplified approach of a realistic setting. Similarly, it lowers early-onset ventilator-associated pneumonia as the minimum requirements for compliance in every proposed bundle component for ventilator-associated pneumonia ought to be validated separately to evade unnecessary workload.

It is therefore important to have a training of healthcare personnel as a precondition for controlling infection in all the intensive care units, especially those that are characterized by limited resources, to raise the rate of compliance with the established guidelines (Bassetti et al., 2016). The infections have various aspects that need to be considered. They include definitions, risk factors, etiological agents, diagnosis, treatment, and prevention, emphasizing the recent advances on health issues. Generally, ventilator-associated pneumonia is a well-known infection that leads to the complication of invasive mechanical ventilation in critically ill patients using mechanical support for respiration.

Conclusion

Generally, many research studies have been staged to get a long-lasting solution towards the reduction of ventilator-associated pneumonia; the use of non-pharmacological interventions will help a great deal in curbing the spread. Many trials by medical practitioners are certainly clear evidence that the medical field has limited capability in controlling the spread of ventilator-associated pneumonia. It is because most patients suffer from the same need mechanical support to have a functional respiratory process during inhalation exhalation in their lungs. There has been disagreement on the treatment measures on ventilator-associated pneumonia, and this serves a burden to the medical field. Therefore, to reduce the rate of the contraction rate by patients in mechanical support, innovative diagnostic markers in the medical field should advise on non-pharmacological interventions to prevent further spread and help reduce ventilator-associated pneumonia.

References

Bassetti, M.Niederman, M. S., Alder, J, Boateng, F., Cao, B., Corkery, K., ... & Nicolau, D. P. (2020). Inhaled amikacin adjunctive to intravenous standard-of-care antibiotics in mechanically ventilated patients with Gram-negative pneumonia (INHALE): a double-blind, randomized, placebo-controlled, phase 3, superiority trial. The Lancet Infectious Diseases, 20(3), 330-340.

Boltey, E., Yakusheva, O., & Costa, D. K. (2017). 5 Nursing strategies to prevent ventilator-associated pneumonia. American nurse today, 12(6), 42.

Romero, A, Rello, J., Ramírez-Estrada, S, A., Arvaniti, K., Koulenti, D., Nseir, S., ... & Peña-López, Y. (2019). Factors associated with ventilator-associated events: an international multicenter prospective cohort study. European Journal of Clinical Microbiology & Infectious Diseases, 38(9), 1693-1699.

Timsit, J. F., Schwebel, C., Styfalova, L., Cornet, M., Poirier, P., Forrestier, C., ... & Souweine, B. (2019). Impact of bronchial colonization with Candida spp. on the risk of bacterial ventilator-associated pneumonia in the ICU: the FUNGIBACT prospective cohort study. Intensive Care Medicine, 45(6), 834-843.

Torres, A., Niederman, M. S., Chastre, J., Ewig, S., Fernandez-Vandellas, P., Hamberger, H., ... & Paiva, J. A. (2017). Ventilato-associated infections control.

Yilmaz, D., Düzgün, F., Erari, G., & Dikmen, Y. (2019). Practices and Attitudes of Intensive Care Nurses towards Oral Care Which Plays a Key Role in Preventing Mechanical Ventilator-Associated Pneumonia. Journal of Nursing Science & Practice, 9(2), 11-18.