Preventing Ventilator-associated pneumonia
P __Population/patient
=
Critical care patients on ventilators
I __ Intervention/indicator
=
increased frequency of hand washing and strict disinfection as measures to prevent the development of ventilator-associated pneumonia in critical care patients.
C__Comparator/control
= Critical care patients in whom this intervention is not performed.
O __Outcome
= Ventilator associated pneumonia is prevented in critical care patients.
T__Time of discharge
In line with the PICO format, the PICO question would be, "how does increased frequency of hand washing and disinfection affect the development of ventilator assisted pneumonia in critical care patients?"
In carrying out this research, I have identified an issue which is the issue of preventing the development of ventilator associated pneumonia in critical care patients.
The population at risk includes critical care patients who have been intubated for more than 48 hours. A characteristic of this group is that they are not ambulatory and also, because they are not able to respire spontaneously, they have been placed on a ventilator machine so that their respiration is assured. Assisted ventilation involves the passage of an oropharyngeal airway. Prolonged use of the oropharyngeal airway for more than 48 hours is associated with increased risk of development of pneumonia.
Rate of pneumonia are said to be high in hospitalized patients. It is said to be even higher in patients hospitalized in intensive care units. The risk of pneumonia is also increased 3 - to 10- fold in intubated patients (Chastre & Fagon, 2002).
The intervention is a program to prevent the development of ventilator-associated pneumonia in these patients. The intervention involves increased frequency of hand washing in the patient. The control group would be patients who are also on assisted ventilation but the frequency of hand washing is not increased.
The outcome expected would be the confirmation that increased frequency of hand washing and disinfection prevents ventilator associated pneumonia in critical care patients.
References
Jean, Chastre & Jean-Yves Fagon (2002). Ventilator-associated Pneumonia. State of the Art. Am J Respir Crit Care med Vol 165. pp 867-903, 2002. DOI 10.1164/rcm.2105078
E, Bouza et al (2001). Ventilator-associated pneumonia. A, torres & J, Carlet(eds).European Task Force on ventilator-associated pneumonia
