Introducing evidence-based practice
Part 1
Ventilator-associated pneumonia (VAP) is a lung infection that is usually brought about by a critically ill patient being fitted with mechanical ventilators which are beneficial for their breathing system. The condition has been identified as a major factor contributing to morbidities and mortalities amongst patients in the acute care settings. Additionally, individuals who acquire VAP while in the critical unit stay longer in the hospital a factor which adversely impacts on their satisfaction levels and outcomes. The ventilators fitted onto these critically ill patients may be helpful in addressing their breathing problems even though there are challenges that are usually associated with using them. In the event that they are not well observed, they usually act as a leeway through which disease-causing pathogens end up in the patient’s lungs (CDC, 2016). The standard practices that have to be observed in addressing this problem are by making sure that the patient can breathe on their own thereby reducing the employment of the ventilator in the care provision process. Nurses are also tasked with ensuring cleanliness of their hands before and after touching the ventilator by the use of alcohol-based hand wash or soap and water. The equipment used on different patients is supposed to be cleaned. Finally, the inside the patient’s mouth needs to be checked regularly.
In addition to the standard care practices, elevating the head of the patient’s bed to a position between 30° and 45° has been observed as a useful intervention in addressing VAP. According to the guidelines provided by the National Guideline Clearinghouse on VAP, the head of the bed of a patient is supposed to be elevated at an angle between 30° to 45° for patients who are being assisted in breathing using mechanical ventilation (National Guideline Clearinghouse, 2015). This recommendation has been proposed in the event that medical contraindications are not available. It should be noted that maintaining the bed at an angle lower than 30° has very minimal successes in preventing the condition.
Part 2
The ACE Star model is essential in understanding the nature and general characteristics of the bodies of knowledge used in providing evidence-based care to patients. This model incorporates old and new models in the care provision process with the intentions of utilizing the most suitable practices (Texas University Health Science Center, 2015). For instance the model can be used to assess the suitability of elevating the head of patient on ventilator and other standard practices such as maintaining oral hygiene of the patient (CDC, 2016). Such a model is beneficial in addressing problems brought about by VAP since it takes into consideration the nursing profession in utilizing the EBP in serving patients. It is made up of five steps.
Step 1: Discovery Research
This is the knowledge discovery stage where traditional and scientific inquiries concerning a particular disease are made. The research is carried out using randomized tests, causal relationships, and qualitative studies.
After carrying out the discoveries, the knowledge gotten is converted into meaningful statements which are useful in scientific terms. This step focuses on using randomized controlled trials and summarization. As such, this stage is the knowledge generating phase. This phase assists in reducing large quantities of research to manageable sizes.
Step 3: Translating knowledge into guidelines
This step incorporates the translation and integration of data into practice that can comfortably address the costs, time and standard care practices of addressing VAP (Texas University Health Science Center, 2015). It is from this phase that clinical practice guidelines are generated to be used in the nursing of these patients.
Step 4: Integration into practice
This stage is useful both to healthcare providers and the organization since it makes use of both official and unofficial conduits. The factors that are given attention in this phase are the rate at which the organization will adopt these practices in addition to the aspects that have to be considered in changing the practices into a suitable system.
Step 5: Evaluation of the process outcomes
The generated knowledge in addressing VAP is then evaluated in terms of outcomes on the patients, efficiency levels, patient satisfaction, the impact on the health status of the VAP patient and the economic effects of the changes. This phase is aimed at improving the overall well-being of patients.
Part 3
Rationale for using the model
Based on the fact that this model is vital shows the various ways through which knowledge is converted into practice by following the cycles, it provides a framework which is useful in translating EBP models into practice. Additionally, the knowledge generated is also important since it is classified according to its strengths. Such a realization is important in the care provision process since the practices being used have been tested and proven in showing a cause and effect relationship (Texas University Health Science Center, 2015). Consequently, the model is essential in addressing VAP since it examines and applies EPB practice within the required confines of medical attention.
References
CDC. (2016). Ventilator-Associated Pneumonia. Retrieved from http://www.cdc.gov/HAI/pdfs/vap/VAP_tagged.pdf
National Guideline Clearinghouse. (2015). National Guideline Clearinghouse | Prevention of ventilator-associated pneumonia. Health care protocol. Retrieved from http://www.guideline.gov/content.aspx?id=36063&search=ventilated+associated+pneumonia
Texas University Health Science Center. (2015). The ACE Star Model. Retrieved from http://nursing.uthscsa.edu/onrs/starmodel/star-model.asp
