Pneumonia Evidence Based Problem Essay

Total Length: 628 words ( 2 double-spaced pages)

Total Sources: 2

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Evidence Based Problem: Article Reviews

According to standards of evidence, the highest level of quality (Level 1) is that of a systematic review involving randomized controls to eliminate bias. On a lower level of quality (Level 3), that of systematic reviews of lower-quality studies, different types of methods may be used. In answer to my question regarding the Fowler’s positioning of mechanically-ventilated patients to reduce the risk of pneumonia on medical-surgical units, I first consulted a systematic review of the risks of pneumonia in general for patients. In a Level 4 systematic review conducted by Almirall (et al., 2017) of risk factors for community-acquired pneumonia (CAP), 29 observational studies including cross-sectional, case-control, and cohort studies were reviewed to assess risk factors for adult hospitalized patients for developing pneumonia. The studies all attempted to study different, albeit similar, risk factors.

In the Almirall (et al., 2017) review, the confirmed risk factors included advanced age; being a smoker; a history of environmental exposure to negative toxins; malnutrition; a history of previous CAP; and respiratory complaints like bronchitis, COPD, and asthma. Other exacerbating factors included poor dental health and having being treated with certain kinds of classes of pharmaceuticals, such steroids and gastric-acid or immunosuppressive drugs.
This is useful to determine the highest-risk patients and to see which patients might show the greatest benefits from repositioning to preventative care. Other factors which were subject to scrutiny but on which no conclusive evidence emerged include gender, weight, alcohol use, vaccination status, and other chronic ailments such as diabetes and cancers.

Along with a systematic review, another study which was consulted included a Level 4 peer-reviewed single quantitative study by Kubota, Endo, & Kubota, (2013) which involved the positioning of patients in Fowler’s position to reduce the risk of cardiovascular events through improved cardiac regulation. In contrast to a systematic review, which involves multiple studies, this review merely involved a single study. The study hypothesized that slight postural differences would make relatively little difference on the health of patients, based upon the fact that blood volume distribution would not change very much with increases in upper torso flexion. Measurements of 12 patients in the study included respiratory sinus arrhythmia (RSA) and sequence baroreflex sensitivity (sBRS).

The subject population of the study was relatively limited, however, and was healthy rather than had a history of previous complaints. The findings yielded suggested vagal….....

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"Pneumonia Evidence Based Problem", 22 July 2018, Accessed.14 May. 2025,
https://www.aceyourpaper.com/essays/pneumonia-evidence-based-problem-2171841