Effectiveness of Chlorhexidinein Reducing Ventilator Associated Pneumonia Capstone Project

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PICOT

In critically ill adults (p), how does the daily use of chlorohexidine (I) compared to sterile water reduce VAP (ventilator-associated pneumonia) (O) during hospitalized stay (T).

Part 2 Identifying a Problem

Of the infections acquired by patients who've used mechanical ventilation in hospitals, ventilator-associated pneumonia is the most common. It causes several deaths, prolongs hospital stay and adds to the cost of medical care. Ventilator-associated pneumonia is commonly developed when pathogenic bacteria colonize the aero digestive tract. Given this reality, prevention of the infection has always involved preventing bacteria colonization and the following aspiration of the contaminated secretions to the lower airways. (Babcock et al., 2004).

It is necessary that a reappraisal be carried out because of the limitations that the evidence base has. First, the current meta analyses are influenced heavily by three significant studies in patients undergoing cardiac surgery and they accounted for between forty to sixty percent of the patients analyzed before. The reliability of the studies lie in question because most of the patients' extubation is done within a day. VAP is the least likely outcome in such a situation. Second, not enough distinction has been made between double-blind and open-label investigations. This is key because VAP diagnosis is not always accurate and objective. It is hard estimating VAP rates because objectivity and specificity are always lacking.

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The study reappraised evidence base that support admitting oral care to mechanical ventilation patients with chlorohexidine. The study looked into what impact chlorohexidine had on oral care, VAP and ICU length of stay (Klompas et al., 2014).

Reducing the volume of oral microorganisms could help make significant strides in preventing VAP. Chlorohexidine might just hold the answer. It helps fight both aerobic bacteria and anaerobic bacteria. It can be active for long -- 6 hours after application. The question as to whether Chlohexidine is the best choice is still open to discussion (Zhang, Tang & Fu, 2014). Clinical workers are for sure free to make a decision based on the circumstances and their judgment of the needs of the patient.

VAP prevention will require thorough education of all concerned parties. It was found that 2 community hospitals and 2 teaching hospitals had dropped the infection rate by on average 46% after the staff had gone through professional development. VAP infections should be brought to near zero whatever the cost. It leads to higher medical care costs, lengthens hospital stay, raises patient morbidity and increases the workload of health workers. Education should therefore be a key priority (Pruitt & Jacobs, 2006). CDC states (Tablan et al., 2004) that preventing VAP needs the employment of a multifaceted approach. Oral care should be one.....

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