Currently, in intensive care units, ventilator-associated pneumonia or simply VAP is a life-threatening nosocomial infection. Generally, the diagnosis of this infection is more difficult to establish because it is often confused with other respiratory diseases. This type of pneumonia occurs typically within 48 and 72 hours and characterized by systematic symptoms, which include fever and alterations on the number of white blood cells in the body. For the quality care benchmark, the infection concept of ventilator-associated difficulties has been projected as a surrogate for ventilator-associated pneumonia. Because of the challenging aspect of diagnosis of the VAP, the Centers for Disease Control and Prevention uses different combinations of diagnosis criteria, including radiographic, clinical, and microbiological. With the absence of a benchmark diagnosis, the correct diagnosis and treatment of ventilator-associated infection are usually limited.
Today, the main problem in healthcare concerning the ventilator-associated infection is determining the accurate diagnosis of it due to various confusion that usually occurs. The bacterial infection normally colonizes the lungs leading to reduced immune response and the occurrence of the infection. There is a need for the health care professions to find evidence-based practices to limit the progression of this infection in the healthcare setting. From the statistics, it is evident that, indeed, ventilator-associated infection is the second leading cause of death to critically ill patients with incidences ranging from 10 to 67 percent depending on the diagnostic criteria.
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PICOT usually formulates clinical questions and provide answers to them to provide assistance in researching more on the issue. In my search strategy, the population will be the patients on mechanical ventilators undergoing intensive care. The use of these kinds of patients in my search strategy is to ensure that I acquire accurate and firsthand information concerning the VAP rate in intensive care units. The intervention in my search strategy is to develop evidence-based practices while considering the physicians and the patient's demands on oral hygiene care to patients on mechanical ventilators aimed at reducing VAP infection in the healthcare setting.
The comparison in my search strategy is comparing the use of correct oral care to patients on mechanical ventilators compared to unhygienic control measures aimed at reducing the occurrence of VAP complications. The outcome of the study is to minimize VAP complications by implementing oral hygiene care in the hospital setting. The time required after the implementation of hygienic oral care by healthcare professionals is 24 hours. My PICOT question is "how the problem of ventilator-associated pneumonia can be reduced in the healthcare setting by healthcare professionals adhering to hygienic measures during critical care of the patient and also comparing them with unhygienic measures.” This paper aim is to ascertain the problem of ventilator-associated pneumonia in mechanically ventilated patients receiving critical care.
Level of Evidence
It is crucial to identify various information about the research issue that is supported by evidence to continue with any research. I have to utilize mixed research methods to undertake my research to satisfy this claim. I will employ qualitative and quantitative research methods, which will enable me to obtain reliable data vital for my research. In my study, a qualitative research method will be utilized to obtain information directly from the patients' experience while receiving critical care. Some of the questions asked during this research method include patient satisfaction on the care provide by the physicians. Quantitative research designed will be employed when examining the cause and the effects of ventilator-associated pneumonia on critically ill patients. The literature review on the topic will also be of great help in supporting the VAP complication among critically ill patients.
Search Strategy
While searching for the relevant articles for the project, I searched for “update on ventilator-associated pneumonia” and “ventilator-associated pneumonia: present understanding and ongoing debate.” Initially, when conducting my research, I utilized PubMed in conduction the research and later on found the articles from the US national library of medicine and Springer Link.
In conducting my research, I utilized the subject "ventilator-associated pneumonia," which resulted in several articles that had previously handled the topic. To narrow my research down, I looked for articles that are more specific to the topic and more so articles published not more than six years. I, therefore, found the two articles as relevant to the topic from the US national library of medicine and Springer Link.
The two identified articles are relevant to the topic of further research. The research on ''ventilator-associated pneumonia: present understanding and ongoing debate '' conducted by Niederman and Nair and the research on " update on ventilator-associated pneumonia " undertaken by Timsit, Esaied, Neuville, Bouadma, and Mourvllier provide clear and well-researched topic on ventilator-associated pneumonia complication in healthcare settings. The two articles aim at evaluating the problem of ventilator-associated pneumonia that has long resulted in deaths among critically ill patients in the healthcare setting. In this essay, I chose the two articles because they provided evidence-based and up to date information concerning the research issue of VAP complications.
References
Nair, G. B., & Niederman, M. S. (2015). Ventilator-associated pneumonia: present understanding and ongoing debates. Intensive care medicine , 41 (1), 34-48. ). Retrieved from: https://link.springer.com/article/10.1007/s00134-014-3564-5
Timsit, J. F., Esaied, W., Neuville, M., Bouadma, L., & Mourvllier, B. (2017). Update on ventilator-associated pneumonia. F1000Research , 6 , 2061. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710313/
