Health Care and Compliance Essay

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Compliance to Ventilator Care Bundles on Reducing Ventilator-Associated Pneumonia

Ventilator-Associated Pneumonia (VAP) is a common infection that is acquired by patients who have used mechanical ventilation in health care facilities. This infection has generated numerous concerns in public health because of its negative impacts on health care. Some of these negative health effects include extended hospital stays, increased costs of health care services, and deaths. Consequently, there have been numerous initiatives in healthcare to address this problem including ventilator care bundles. Existing literature on evidence-based practice for dealing with VAP has shown that compliance with ventilator care bundles is the most suitable clinical intervention (Al-Thaqafy, 2014). For this study, the John Hopkins Nursing Evidence Practice Process will be utilized to facilitate compliance to these bundles in order to reduce VAP. John Hopkins developed an equation that helps administrators quantify probable savings through lessening hospital-acquired infections like VAP (Guterl, 2013). This process will entail research (reviewing existing literature on the topic), conducting nursing education, and implementing suitable nursing practices.

Step 1 -- Recruit Interprofessional Team

A dedicated interprofessional or multidisciplinary team is crucial towards compliance to ventilator care bundles to reduced VAP infections. This interprofessional team will consist of five members who will be part of the primary intensive care unit. These members will include a physician, a respiratory therapist, a pharmacist, a charge nurse, and a clinical nurse specialist.

Step 2 -- Develop and Refine the EBP Question

In regards to patients on ventilators, how effective is compliance to VCP bundle protocols vs. noncompliance with VC bundle protocols in reducing the risk of patients acquiring Ventilator Associated Pneumonia. The population of interest is patients suffering from Ventilator Associated Pneumonia while the intervention in compliance to VC bundle protocols. The comparison is whether compliance to VC bundle protocols lessens risk of acquiring VAP as compared to noncompliance whereas the outcome is reduced VAP infections.

Step 3 -- Define the Scope of the EBP

Recent studies have indicated that VAP has an incidence rate of between 5% and 67% in intensive care units and a mortality rate of between 24% and 76%. The condition contributes to extended hospital stays by approximately 9 days and increases the costs of care. This essentially means that VAP is a public health problem because of its considerable negative impacts including extended hospital stays, increased costs of health care services, and death (Lawrence & Fulbrook, 2011).

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Therefore, VAP impacts healthcare through increasing hospitalization, generating poor clinical outcomes, and increasing costs of care (Guterl, 2013).

Step 4 and 5 - Determine the Responsibility of Team Members

The physician will help coordinate care in a manner that complies with VC bundle protocols to reduce risk of VAP infections. The role of the pharmacists will be to provide proper medication based on physicians recommendations while the respiratory therapist will examine the patient's respiratory health and provide modifications and/or recommendations for preventing VAP. The nurse will help ensure that the patient maintains good oral hygiene and maintain him/her in a semirecumbent position while the charge nurse specialist measures compliance with VC bundle protocols.

Step 6 and 7 -- Conduct Internal/External Search and Appraisal of Evidence

Existing studies recommend compliance with VC bundle protocols as evidence-based practice guidelines for lessening this hospital-acquired infection. A qualitative research by Lawrence & Fulbrook (2011) states that implementation of VC bundles is associated with improved clinical outcomes. The strength of this qualitative research is that the exploration was carried out on several studies that were published between 2004 and 2009. A quantitative study by Rello et al. (2012) contended that implementing VC bundles reduces risk of VAP infection and its associated health effects on patients. The strength of this study is that the cohort research was carried out in five Spanish adult intensive-care units. The position of these studies is that evidence-based practice demonstrates that compliance to VC bundles not only reduces VAP but also mitigates its impacts on patients.

Step 8 and 9 -- Summarize the Evidence

Rello et al. (2012) found that high compliance with VC bundle protocols helps in preventing VAP infections in intensive care units while low levels of compliance also generate significant benefits. Lawrence & Fulbrook (2011) seemingly disagrees by arguing that a definite causal link between use of VC bundles and….....

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