Case Study Of Pneumonia And Chronic Pulmonary Disease

Case Study Of Pneumonia And Chronic Pulmonary Disease
Case Study for Pneumonia Our nose and airway filters germs out of the air that we breathe in order
to prevent our lungs from becoming infected. However, when germs does enters our lungs, it may
cause infections such as Pneumonia which inflames the air sacs of the lungs, which can range from
mild case to severe cases. The air sac may be filled with fluid or pus causing cough that associates
with phlegm, fever, chills and difficulty breathing. The causes of pneumonia are extrinsic and
intrinsic. The extrinsic factors include exposure to pulmonary irritants or pulmonary injury such as
those who works in construction or agriculture. Inhaling dusk, chemicals and air pollution or toxic
fumes can damage your lungs and make them more vulnerable for infection. Intrinsic factors are
related to the host such as stroke, endotracheal intubation, diabetes, chronic pulmonary disease,
human immunodeficiency or emphysema. Smoking and alcohol abuse could also be a factor because
it damages the cilia in the lungs that help remove bacteria and germs. Alcohol abuse can put you at
risk of aspiration pneumonia especially when you vomit and the small particles enter your lungs. In
addition, alcohol interferes with the white blood cell production which us responsible in fighting
infection in our body. Types of Pneumonia and Risk Factors There are several types pneumonia and
each are named on how an individual is infected or for the germs that causes it. However, in this
case study, the focus
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Pneumonia Severity Index
Pneumonia severity index (PSI) is a score based on patient age, medical history, current symptoms,
vital signs, and blood work. Reference? Each value will have a score given if it meets the criteria.
All of the scores are added up giving a total score that puts the patient into a risk category. The
pneumonia severity index has five risk categories based on the score. The risk factor category that
the patient falls under will help the health care provider determine how to go about treating the
patient's community acquired pneumonia. Risks 1–3 are considered low risk and the patient can be
treated as an outpatient. Risks 4–5 are considered to be of high risk and the patient should be
admitted to the hospital for treatment. Reference? With this

Hospital Acquired Pneumonia Research Paper
Ventilator–associated pneumonia is defined as pneumonia arising 48 hours or more after
endotracheal intubation whereas pneumonia is defined as the presence of "new lung infiltrate plus
clinical evidence that the infiltrate is of an infectious origin, which include the new onset of fever,
purulent sputum, leukocytosis, and decline in oxygenation." Together with hospital–acquired
pneumonia (HAP) are the most common hospital–acquired infections. In a prevalence study in
USA, they accounted for 22% of all hospital–acquired infections [1]. VAP is the commonest
nosocomial infection in the Intensive Care Unit
(ICU) and in a recent survey from the USA, VAP affected 10% of patients requiring mechanical
ventilation ... Show more content on Helpwriting.net ...
Host factors, the virulence of bacteria, and most importantly the presence of an endotracheal tube
determine the development of VAP. The tube is detrimental not only because it provides the conduit
for bacteria, but also because it abolishes the cough reflex.
Bacteria get access to the lungs via microaspiration and through the biofilm that is formed in the
inner surface of the endotracheal tube or leakage of secretions around the cuff. Spread from an
adjacent site of infection or via the blood represent rare causes of VAP. Pathogenic bacteria usually
replace endogenous flora and colonize the nasopharynx, the oropharynx, the sinuses and the
stomach subsequently collecting inside and around the endotracheal tube. Positive pressure
ventilation also contributes to VAP development by thrusting bacteria into the airways. Antibiotic
exposure, severity of underlying disease and previous surgery have been implicated as host factors
[5,8].
Various strategies have been applied for the prevention of VAP, each with different levels of
evidence. Preventive measures against VAP development can be divided into five distinct groups:

Ventilator-Associated Pneumonia Essay
Ventilator–Associated Pneumonia: A Quantitative Research Study Vanesia Davis Kelly Grand
Canyon University Intro to Nursing Research–NRS/433V April 15, 2012 Ventilator–Associated
Pneumonia Ventilator–associated pneumonia is a bacterial infection that occurs in the lower
respiratory system within the first 48 hours of endotrachal intubation (Lewis, Dirksen, Heitkemper,
Bucher, & Camera, 2011). Although any hospital patient is susceptible to pneumonia, ventilator
dependent patients are at the highest risk of acquiring pneumonia. The purpose of this paper is to
identify the risk factors, incidences, and preventions of ventilator–associated pneumonia (VAP)
using a quantitative research study performed in Malaysia. "The aim of this ... Show more content
on Helpwriting.net ...
According to Lewis et al (2011), early VAP, the first 96 hours, sputum cultures often grow gram–
negative microbes. However, organisms of late VAP were associated with antibiotic resistant
microbes. Microbes resistant to antibiotics abundantly consume the hospital. For the collection of
data, developed and verified NI surveillance was used. The NI surveillance was useful for
measuring both the incidence and risk factors of VAP according to Katherason et al (2009).
Demographical data, past medical history, medications, nutritional status, laboratory results,
diagnosis, history of illness, etc were all included in the surveillance. The Acute Physiology and
Chronic Health Evaluation III score measured the severity of the illness. The APCHE is comprised
of the acute physiological score that entails the major physiological systems and the chronic health
evaluation that incorporates the influence of co–morbid conditions on the patient's current health
(O'Keefe–McCarthy, Santiago, & Lau, 2008). During the surveillance, data from nursing
documentation, physician progress notes, laboratory results, and direct observations. Data was
collected from the time of admission until the diagnosis of VAP was made. The patients who were
discharged from the ICU and sent to a regular medical surgical floor were followed for an additional
48 to ensure that VAP would be detected that manifested after the discharge. Risk factors involved
with VAP in the ICUs are

Ventilator Associated Pneumonia Prevention And Ventilator...
Ventilator–Associated Pneumonia Prevention
Leonard, T. N.
Thomas Edison State College
Abstract
Ventilator–associated pneumonia (VAP) remains a big drawback within the hospital setting, with
terribly high morbidity, mortality, and cost. Some people tend to perform an evidence–based review
of the literature that specializes in clinically relevant pharmacological and non–pharmacological
interventions to prevent VAP. Thanks to the importance of this condition the implementation of
preventive measures is predominant within the care of mechanically ventilated patients. There is
proof that these measures decrease the incidence of VAP and improve outcomes within the intensive
care unit. A multidisciplinary approach, continuing ... Show more content on Helpwriting.net ...
VAP has been seen to cause up to 71% of hospital pneumonia deaths. According to Koenig (2006),
Ventilator–associated pneumonia is defined as pneumonia occurring more than 48 hours after
patients have been intubated and received mechanical ventilation. Diagnosing VAP requires a high
clinical suspicion combined with bedside–examination, radiographic–examination, and
microbiologic analysis of respiratory secretions. Aggressive surveillance is vital in under–standing
local factors leading to VAP and the microbiologic milieu of a given unit. Judicious antibiotic usage
is essential, as resistant organisms continue to plague intensive care units and critically ill patients.
Simple nursing and respiratory therapy interventions for prevention should be adopted. (para.2) VAP
has two types, early on set (within the first 48 hours), and late on set VAP (after 90 hours). VAP will
usually appear within the first 48 hours after intubation. Diagnosis of VAP can sometimes be very
difficult. The usual and best way to diagnose VAP is to have a portable chest radiograph performed.
According to Koenig (2006),
While the portable chest radiograph still remains a mandatory component in the diagnosis of
ventilated patients with suspected pneumonia, as with clinical criteria for diagnosing VAP, it too has
problems with both sensitivity and specificity. Poor–quality films further compromise the accuracy
of chest X rays.

Evaluation Of An Integrated Care Pathway
INTRODUCTION An integrated care pathway is a structured multidisciplinary synopsis of
anticipated care, placed within a set timeline, to aid a patient with a specific condition or set of
symptoms to move progressively through a clinical experience to positive outcomes, It is one of the
main tools used to manage the quality in healthcare concerning the standardisation of care processes
and therefore promotes organised and efficient patient care based on evidence based practice.
(British Medical Journal, 1998). In this essay I aim to justify a patient pathway of care with
reference to national and local agendas. I will analyse the assessment strategies utilised in the
pathway from a bio–psycho–social perspective with reference to contemporary evidence and
provide examples from clinical practice where assessment of the patient of the pathway impacts
upon the care planning process. JUSTIFY THE SELECTION OF THE PATHWAY WITH
REFERENCE TO NATIONAL AND LOCAL AGENDAS The pathway I have selected to discuss
from pervious placement is the Pneumonia pathway. The national agenda I have chosen heading this
topic is the National Institute for Health and care Excellence (NICE). Under the pneumonia pathway
I will concentrate on the "Adult with community acquired pneumonia path which is within the
pathway. Pneumonia, is a lower respiratory tract infection in which there is an inflammation of the
lung(s) caused by a bacterial, viral or fungal infection. Streptococcus pneumoniae is the most

Health Alteration-Assessment
NUR241– Health Alteration– Assessment Task 3– Case Study Question 1. Question 2. Outline the
pathophysiology of altered ventilation and diffusion in relation to Mr Hunter's pneumonia. –Ask
yourself– what is altered ventilation and diffusion? Then compare and see what the differences are.
Why is this important in relation to Mr Hunter's pneumonia? Question 3. Hospital acquired
pneumonia or (HAP), also referred to as nosocomial pneumonia (Smeltzer & Bare, 2017), is
described as being a lethal nosocomial infection that presents as an onset of pneumonia around
48hrs after the patient is admitted to hospital. The patient may not present with obvious signs or
symptoms of the infection at the time of admission, although they may ... Show more content on
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When CAP occurs, it is determined if the need for hospitalisation is necessary as it depends on the
seriousness of the infection. Gram– positive organisms such as S. pneumoniae, naturally occur in the
upper respiratory tract, is one cause of lower respiratory infections such as pneumonia, but is also a
culprit in causing upper respiratory infections like otitis media. H. influenzae is just one of many
bacterial infections that can result in CAP, it therefore can be subacute and present with a low–grade
fever and a persistent cough for a few weeks before a patient has a diagnosis. Adults that have very
little or no immunity are an easier target for certain viruses such as that of the Cytomegalovirus,
which is a viral pathogen that is commonly contracted within the community, other common virus
are adenovirus and herpes simplex. When a virus starts to become acute, it starts an infection within
the ciliated cells within the airway. When pneumonia occurs from this viral infection, the
inflammatory action starts to seep into the alveolar areas and leads to the problem of excess
exudation and oedema within the respiratory tract. It is sometimes often difficult to differentiate
symptoms of a viral pneumonia from that of bacterial pneumonia (Smeltzer &

Zap Vap Essays
ZAP VAP YVONNE SENTNER WAYNESBURG UNIVERSITY NUR589: EVIDENCE–BASED
NURSING PRACTICE NANCY STYNCHULA, BSN, RN OCTOBER 6, 2010 INTRODUCTION
Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop
while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn,
2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens
when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because
it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are
often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that
... Show more content on Helpwriting.net ...
Nosocomial infections relate directly to nursing care so nurses should understand the
pathophysiology, risk factors, and prevention strategies for VAP. Augustyn (2007) explains there are
two types of VAP, early onset and late onset. Early onset occurs 48–96 hours after intubation and is
associated with antibiotic–susceptible organisms. Late–onset VAP occurs more than 96 hours after
intubation and is associated with antibiotic–resistant organisms. The pathophysiology of VAP
involves two main processes: colonization of the respiratory and digestive tracts and microaspiration
of secretions in the airway. If the patient has preexisting conditions such as immunosuppression,
chronic obstructive pulmonary disease (COPD) or another respiratory disease, the chance of getting
VAP increases. As was previously stated, VAP is caused by bacteria. Bacteria can spread to the lungs
from different sources. These include nares, dental plaque, gastrointestinal tract, patient–to–patient
contact and the ventilator circuit. The endotracheal tube can provide a direct route for bacteria to
enter the respiratory tract. The bacteria come from pooled secretions above the endotube's cuff or in
the upper airway and can get disseminated into the lungs by ventilator–induced breaths. Aspiration
of gastric contents is another potential cause of VAP because the stomach acts as a reservoir for
bacteria. If the patient has a

The Importance Of Educating Hospital-Acquired Infections
Hi Dee, You did an amazing job creating your power point. You provided great information on
hospital–acquired infections. I really enjoyed how you included ways on educating patients to self–
advocate in order to prevent and avoid contracting hospital–acquired infections. The focus on
preventing the spread of infection is mainly geared towards educating healthcare professional and
not always on patients to self–advocate. Both of my parents had their equal share of hospitalizations
as they got older. Every hospitalization that either one of my parents had, I never once heard a nurse
or any healthcare professional offer my parents hand sanitizer or a sanitized wipe to clean their
hands priotr to and after their meals. They also never offered

Birdie: Avian Influenza Virus
Once there was a virus named Birdie. This virus was a Bird Flu, or Avian Influenza, virus of the
subtype H5N1, the first strain of Avian Influenza having the ability to infect humans (Normandin
and Solan). Birdie looked like a microscopic pomander, a fragrant orange with cloves stuck in it.
Inside, she had eight pieces of single stranded ribonucleic acid or ssRNA. Birdie was deadly to
humans, but was not able to spread from one human to another. She could only spread from birds to
humans ("Bird Flu"). Birdie started out inside a chicken named Cluck, where she was formed. A
little while later, Cluck's farmer Mark, sold his Cluck, to Joe, another poultry farmer because Mark
did not realize that Cluck had H5N1. After a few months of Cluck living ... Show more content on
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Joe drove himself to the hospital, where they treated him with oseltamivir ("Bird Flu Symptoms,
Causes, Treatment). Oseltamivir is a medication that is used to prevent Influenza and sometimes
H5N1 ("Prevention and Treatment of Avian Influenza A Viruses in People"). The one catch about
zanamivir is that for it to be effective, the infected person has to be treated within two days of
having the symptoms ("Oseltamivir (Tamiflu) Uses, Dosage, Side Effects"). Luckily for Joe, he had
started feeling symptoms about a day and a half before. The sad thing was that instead of getting
better, his symptoms got worse. He continued having breathing

Community Acquired Pneumonia
CHAPTER I INTRODUCTION Pneumonia is one of the most common infectious diseases
prevalent nowadays and affects all ages. It is an acute or chronic infection of one or both lungs
caused by microorganisms, such as viruses, bacteria or chemical irritants. (Schmitt, 2011) It has
different types, and one of them is Community Acquired Pneumonia (CAP). CAP is a disease in
which individuals who have not recently been hospitalized develop an infection of the lungs. It
occurs because the areas of the lung which absorbs oxygen (alveoli) from the atmosphere become
filled with fluid and cannot work effectively. (Makati Medical Center, 2012) There are many causes
of pneumonia, including bacteria, viruses, mycoplasmas, fungal agents, and protozoa. ... Show more
content on Helpwriting.net ...
4. Evaluate the client's responses towards the interventions. SIGNIFICANCE OF THE STUDY The
results of this case study are intended to give benefit to the following people concerned: To the
patient, who is the primary recipient of care, that through appropriate nursing interventions with the
aid of his family, he would be able to cope up to the effects of his condition. This study will give
appropriate knowledge on how will be the preparation and management in any upcoming
circumstances that may compromise one's well–being. This study would also help the patient to be
more cooperative in the aspect of compliance to the treatment regimen for the improvement of his
health condition. To the family, that they may act as a support to the patient and make necessary
interventions to address their family member's health condition for speedy recovery through health
teachings done by the researchers. This case study helps improve the awareness of each and every
family constituent. It will help them to identify the causes of such illness and will be able to learn
from the said case. This study would also make them aware about the possible complications that
may arise and which of these needs medical interventions. To the student nurses, this study will give
more relevant information about the patient's case and sickness and will provide them knowledge
and understanding about Community Acquired Pneumonia. The application of the

Pneumonia Analysis
The main outcomes were consultation with symptom of lower respiratory infections in the thirty
days. Multivariable analysis controlled for an extensive list of variables related to the propensity to
prescribe antibiotics. Abate uncomplicated respiratory tract infections are the most common acute
illnesses managed in primary care. The GRACE (Genomics to combat Resistance against
Antibiotics for Community acquired lower respiratory tract infection (LRTI) in Europe) trial in
lower respiratory tract infection documented no clear benefit of antibiotics. Major differences were
found between antibiotic prescribing groups for some variables, particularly assessment of severity
and lung findings. Participants prescribed antibiotics immediately were ... Show more content on
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Your physician will diagnose pneumonia based on your medical history, a physical exam, and test
results. Your doctor will listen to your lung sounds and if you have pneumonia your lungs may have
a crackling or rumbling sound when you inhale. Wheezing may also, be heard. Then he/she may
obtain a CXR to determine inflammation in your lungs. A complete blood count is ordered to see if
your immune system is fighting an infection. Also, blood cultures are ordered to find out whether
you have a bacterial infection that has spread to your bloodstream, then your MD can determine
how to treat the infection. There are many different types of pneumonia. Pneumonia is named for
the way in which a person gets the infection or the germ that can cause the infection. There is
community–acquired which is the most common type of pneumonia. These cases occur during
winter months and occurs outside of the hospital. Hospital–acquired pneumonia is more serious than
community–acquired pneumonia because hospitals carry more germs that are resistant to antibiotics.
Atypical pneumonia is a type of community–acquired pneumonia being that it is caused by lung
infections that include bacteria like Legionella pneumophila and Mycoplasma. (Sept,2016).The type
of pneumonia you have and how severe the pneumonia you have determines the treatment.
Antibiotics are the norm for treatment of bacterial pneumonia. Most begin to improve after one to
three days of antibiotic treatment. If there is viral pneumonia, antibiotics will not work. Antiviral
medications will need to be initiated. One to three weeks is the duration of treatment. Vaccines are
available to prevent pneumonia caused by the flu virus and The Centers for Disease Control and
Prevention recommends that "adults who are sixty–five and older should have two pneumococcal
vaccinations. It is usually given between September through November which is called the flu

Community Acquired Pneumonia Essay
According to the Center for Disease Control, pneumonia is considered the leading cause of death of
children less than five years old. However, there is a way to reduce the chance of contacting this
disease. A vaccine called Pneumococcal is available for people to take (Centers for Disease Control,
2014). There is not only one type of pneumonia. The type of pneumonia is based upon the way the
patient contacted the pneumonia. The following are the different types of pneumonia: Community–
Acquired, Hospital Acquired, Health–Care associated, Aspiration, and atypical (National Heart,
Lung, and Blood Institute, 2011). What is pneumonia? Pneumonia is an infection that occurs within
the lungs. It is specifically an infection that occurs within ... Show more content on Helpwriting.net
...
Chest xray can be used but only in severe cases. There are risks to exposing children to radiation.
Antibiotics should be the first choice of medicine that is given to a child with community acquired
pneumonia. Amoxicillin is the antibiotic of choice for those with this infection. If the amoxicillin
does not seem to be helping, the doctor will probably prescribe a different type of antibiotic like
ceftriaxone. Pneumonia may be difficult to treat once acquired but there are several things a person
can do to prevent the infection. Oral care and hygiene are very important factors to reduce the
chance of becoming infected. The patient or patient's caregiver should be warned about the effects
of smoking to the lungs and the increased risk of developing pneumonia. There are specific risk
factors that may informative about their likelihood of developing pneumonia. Age is a major risk
factor for pneumonia, those over 70 years old or under five years old are considered at risk
populations. People who have other chronic or terminal diseases are at risk due to an
immunocompromised immune system. Smoking also increases the chance that someone will contact
an infection (Goss, 2009, p.

The Problem Of Nursing Shortage
Financial Solution With the problem of nursing shortage in the health care setting, this can have a
long term effect on the organization budget as a result of reduction in the quality of care and overall
outcome of the patient's health. The number of nursing staff it takes for the facility to run effectively,
should become a priority for the organization. As the acuity level of the patient's entering the
hospital continues to rise, the number and skills of nursing staff should increase to meet the patient
level of care. Having lower numbers in nursing staff, can result in higher incidences of hospital
acquired pneumonia, urinary tract infection, decubitus and falls with injuries. After conducting an
interview with two co–workers, there ... Show more content on Helpwriting.net ...
As the acuity level of the patient's entering the hospital continues to rise, there is inadequate nursing
staff with the skills and time needed for the patient's as they entered into the health care setting. The
current nursing staff are overworked and burnt out with performing the necessary duties to care for
the patient. The administrators within the hospital have to come up with a resolution for the current
rate of nursing shortage, especially during the between the months of November and February.
During this time, there are high incidences of the patients being admitted to the hospital with
community acquired pneumonia and influenza. The number skilled and available nursing staff is
less than the vision or expectation of the organization. As a result of the nursing staff shortage, this
results in another identifiable problem within the organization such as higher incidence of falls
incidences of falls on night shifts and hospital acquired decubitus. This will affect the budget of the
organization because insurance companies will not pay for hospital acquired falls with the result of
an injury and decubitus. According to Mr. J.G. nursing shortage has always been an issue since he
has been employed at Lexington Medical Center. "We have to utilize agency nurses to fill in the
needs on the unit. There are incentives

Essay On Hospital Acquired Pneumonia
HOSPITAL ACQUIRED PNEUMONIA Hospital do a lot of harm to the sick. But, it is astonishing
to know that it is essential that, the hospital intend to do no harm to their patient. Years ago,
Florence Nightingale seen as the mother of nursing has identified this problem of hospital practice
harming the sick. Despite the intension and the improved practice put in place by the hospital
management, the hospital still harming the sick. Why do sick people still get hurt when they go to
the hospital? The improved practice implemented by the hospital is not good enough. A good
example of hospital doing harm to the sick is the hospital acquired pneumonia. HAP is an infection
picked up in the hospital by patient. This work is about hospital acquired pneumonia. ... Show more
Patient that are on ventilator get to hospital to be treated for their terminal illness, they end up with
hospital acquired pneumonia. HAP is a lungs infection picked up from the hospital that has a
devastating effect on lungs. This infection manifest within few hours or more, succeeding the
admission of the patient (Medilineplus 2015). What is Hospital Acquired Pneumonia about?
Hospital acquired pneumonia can be described as an infection of the lungs obtained during a
hospital stay. It is an onset of infection 48 hours or more after hospital admission (Gloucestershire
NHS 2015). Hospitals in 1876 during the time of Florence Nightingale and the present day hospital,
despite medical and health care advancement. Hospital acquired infection has been responsible for
large number of patient infections and death (Gallagber 1999). Studies shows that, HAP causes 15%
of hospital acquired infection. And it is the main cause of nosocomial death (Schleder 2004). This
high death rate is not what the hospital bargain for. Hospitals are equipped with improved
equipment's and qualified medical personnel. Patient are still dying of acquired infection from the

Ventilator-Associated Pneumonia Case Study
Impact of the International Nosocomial Infection Control Approach on Rates of Ventilator–
Associated Pneumonia in Hospitals of 5 Within Argentina
Shelby L. Stone
SFCC
January 11, 2018
Abstract
This paper explores a published article that reports on results from research conducted using
International Nosocomial Infection Control Consortium Surveillance Online System. To analyze the
impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional
approach (IMA) on ventilator–associated pneumonia (VAP) rates in eleven hospitals within five
cities of Argentina from January2014–April 2017. The article found in the American Journal of
Infection Control is supported by Victor D. Rosenthal, and the Foundation to Fight against
Nosocomial Infections. Keywords: Hospital infection, Healthcare acquired infection, Hospital–
acquired pneumonia, Nosocomial pneumonia, Limited–resource countries, Surveillance
Impact of the International Nosocomial Infection Control Approach on Rates of Ventilator–
Associated Pneumonia in Hospitals of 5 Within Argentina ... Show more content on Helpwriting.net
...
According to studies from both developed and limited–resource countries, the most important
clinical consequences due to VAP have increased death rates, significant disease, increased the
length of stay, and additional health care costs. Although hospitals in limited–resource countries do
implement infection control programs, agreement with infection control practices is inconsistent. A
multicenter, potential, before–after observation study was conducted using International Nosocomial
Infection Control Consortium Surveillance Online System. (V.D. Rosenthal et al/American Journal
of Infection Control

Introduction. The Lungs Are One Of The Most Vital Organ
Introduction The lungs are one of the most vital organ in the body. Without the lungs, the body will
not be able to oxygenate the organs needed to sustain life. Oxygen is the primary driving force that
living organisms need to oxidize food, produce adenosine triphosphate and metabolize energy.
Despite the importance of this organ, millions of Americans acquire pneumonia which ultimately
leads to injury and damage of this vital organ. Although, there are treatments for pneumonia,
education is the most critical aspect we can teach our patients. Through education, we can enhance
patient knowledge and promote self–care behaviors. According to Hinkle, "Influenza and
pneumonia were the eighth leading cause of death in the United States in ... Show more content on
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Just to name a few, here are the most influential pathogens for CAP: haemophilus influenza,
mycoplasma pneumoniae and viral pneumoniae (adenovirus, varicella zoster). Lastly, VAP occurs in
the hospital setting and typically involves patients who underwent endotracheal intubation or
received mechanical ventilator support. Methicillin drug resistant bacteria is the main pathogen
responsible for VAP. In order, to understand pneumonia, it is imperative to recognize the
pathophysiology behind this disease. The development of pneumonia is influenced by internal and
external factors. Intrinsic factors that increase your chances of developing a respiratory infection
include loss of gag reflex, altered level of consciousness and strokes. Loss of gag reflex allows the
pathological agents to enter the lungs freely with no resistance. On the other hand, extrinsic factors
include pulmonary irritants, parenchymal injury and exposure of the pathogenic agents (fungi,
bacteria, parasites, viral). Internal and external factors all enhance the possibility of respiratory
infection, damage and failure. The manifestation of pneumonia is not the same for every patient.
Early signs and symptoms for a viral infection include: coughing with yellowish green mucus, high
fever, chills, sweating and blue lips. A late manifestation of viral pneumonia includes: muscle pain,
shortness of breath and severe pounding headache.

Hospital Acquired Pneumonia Case Study
Hospital Acquired Pneumonia
October 7, 2010
Hospital Acquired Pneumonia
Hospital acquired pneumonia is currently the second most common nosocomial infection in the
United States and is associated with high mortality and morbidity (Seymann, 2008). This paper is a
case study of a 52 year old female who was in the hospital for a scheduled gastric bypass surgery.
During a post–op test she aspirated dye thus beginning the process of her developing nosocomial
pneumonia. The patient was discharged only to return to the emergency department the following
day presenting with signs and symptoms of pneumonia. This paper will discuss her diagnosis,
treatment, risk factors, nursing care, socioeconomic influences, and diagnostic ... Show more
Ms. G. was admitted to the hospital for scheduled gastric bypass surgery on 9/14/2010. On
9/15/2010 she aspirated dye during a post–operative test. This began the process of aspiration
caused pneumonia for Ms. G. Signs and symptoms of respiratory problems began immediately.
However she was released on 9/17/2010. She was admitted for pneumonia on 9/18/2010. Ms. G.
stated that "the two radiologists began arguing because the first radiologist was forcing me to drink
faster than I could tolerate due to my gastric bypass surgery." She began choking on the dye and
aspirated it into her lungs.
Being a single parent to a teenager, Ms. G. has severe anxiety related to being sent home without
any type of oxygen supplementation and not being able to breathe, which is exactly what happened
after her gastric bypass surgery. Ms. G also was very concerned about the fact that she had planned
out her gastric bypass surgery knowing she had only a certain amount of sick pay to cover the
missed time from her job. As a result of acquiring the nosocomial pneumonia – she is now faced
with losing additional time from work – with no pay. Recovering from the severity of her illness
could possibly take weeks during which time she will have no income.
Clinical Manifestations The clinical manifestations of pneumonia will be different according to the
causative organism and the patient's underlying conditions and/or comorbidities (Smeltzer, et al).
Some of the manifestations are

Correlation Between Acute Dysglycemia And Death Essay
The study Serum Glucose Levels for Predicting Death in Patients Admitted to Hospital for
Community Acquired Pneumonia: Prospective Cohort Study was published by the British Medical
Journal (The BMJ) in the journal volume 344, number E3397, on May 29th of 2012. The study was
conducted by consultant physician Philipp M. Lepper, consultant physician Sebastian Ott,
statistician Eveline Nüesh, consultant physician Maximilian von Eynatten, consultant physician
Christian Schumann, professor Mathias W. Pletz, statistician Nicole M Mealing, professor Tobias
Welte, professor Torsten T Bauer, professor Norbert Suttorp, professor Peter Jüni, professor Robert
Bals, and professor Gernot Rohde, on behalf of the German Community Acquired Pneumonia
Competence Network (CAPNETZ). This article consisted of 12 pages and it purpose was to study
the correlation between acute dysglycemia and death in patients admitted to hospital with
community acquired pneumonia. The study was designed as a prospective cohort study between
Germany, Switzerland, and Austria and it was conducted between 2002 and 2009. This prospective
study supports the theory of previews smaller retrospective studies that show the association
between hyperglycemia on hospitalization with mortality in patient with community acquired
pneumonia. Between July 2002 and December 2009, a group of consultant physicians, statisticians,
and professors from Germany, Switzerland, and Austria conducted a study on behalf of CAPNETZ,

Symptoms And Symptoms Of Bacterial Pneumonia
Bacterial Pneumonia Lucas Nguyen Medical terminology 161 Night Session 7:00–9:50pm October
27, 2016 II. Introduction Bacterial pneumonia is an infection of the lungs that can make it difficult
to exchange gases. It can cause inflammation in the alveoli that fill up with fluids, which the lungs
will become less elastic and cannot take oxygen or remove carbon dioxide in the blood efficiently.
Therefore, it can be difficult to breathe for your lungs may need to work harder to retrieve oxygen
and chest pain may occur as well. I chose bacterial pneumonia as my topic because I have a huge
interest in the respiratory system. At San Joaquin Valley College, I was in the respiratory therapist
program where I wanted to write about bacterial pneumonia. Unfortunately, I had to leave before I
can even start the paper about this pulmonary disease. III. Medical Terminology 1. Abdominal: The
anterior portion of the body between the thorax and the pelvis; contains the abdominal cavity. Called
also belly and venter. 2. Arterial: Pertaining to an artery or to the arteries. 3. Bacterial: An acute
croup like bacterial infection of the upper airway in children, with coughing and high fever. 4.
Bradycardia: Slowness of the heartbeat, so that the pulse rate is less than 60 beats per minute or less.
5. Bronchitis: Inflammation of one or more bronchi. 6. Bronchoscopy: Inspection of the interior of
the tracheobronchial tree through a bronchoscope, usually a fiberoptic

Symptoms And Symptoms Of Pneumonia
What is Pneumonia? Pneumonia is an infection of the lungs that makes the individual whom has it
very sick and weak. The infection is caused by bacteria or by a viral infection, which is a disease
that is caused by different types of viruses. Any viral infection can occur in different places in the
body. Some viral infections affect the intestinal tract, while others infect the airways and respiratory
system. Pneumonia can be caused by fungi, bacteria, or a virus. The infection causes the lungs, air
sacs, or alveoli become inflamed. The air sacs in the lungs fill with infected pus or fluid which in
turn makes it difficult to breathe. What are the symptoms of pneumonia? Symptoms of pneumonia
can vary from being mild, to life–threatening. Some symptoms include: –Fever, muscle aches,
fatigue, enlarged lymph nodes in the neck, chest pain, sore throat, coughing that accompanies a
small amount of mucus; shortness of breath, rapid breathing, nausea, and vomiting. Any person with
diabetes could get pneumonia and not even know that they have it because they may only have a
few symptoms. Children with pneumonia will also have symptoms that are not very noticeable and
difficult to diagnose. Children's symptoms include: fever, cough, wheezing, and blue skin. Infants
have even less specific symptoms, such as crying and not eating. The cause of pneumonia:
Pneumonia is caused by many different factors in the environment, some of the causes include:
bacteria, bacterial–like organisms,

Critical Study And Analysis Of Oral Care
The purpose of this document is a critical study and analysis of the oral care provided by nursing
staff as part of the Ventilator Care Bundle (VCB) and to assess whether the frequency of mouth care
performed is related to the prevention of Ventilator Associated Pneumonia (VAP) in patients
mechanically ventilated (Zilberberg et al. 2009).
The following document is a case study written by an intensive care nurse, who will explore the oral
care provided to a patient admitted in an Intensive Care Unit (ICU) and will assess the overall care
process. Additionally, the frequency, products used and techniques performed will be evaluated.
In order to evaluate if mouth care and its frequency are Gold Standard interventions to prevent VAP
... Show more content on Helpwriting.net ...
ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples
devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).
Oral care aims to supply an adequate hygiene level, which leads to reduce colonisation of dental
plaque and oropharynx and to reduce the aspiration of contaminated secretions into the lower airway
(Feider et al. 2010). Research has demonstrated that colonisation of the airway and aspiration of
colonised saliva are the two main pathogenic causes of VAP (Adib–Hajbaghery et al. 2011). Other
cause is the production of a biofilm along the endotracheal tube (ETT) which contains large
quantities of microbes that could be spread into the lungs by ventilator–induced breaths (Keyt et al.
2014; Palomar et al. 2010). Additionally, instilling saline into the ETT, suctioning secretions,
repositioning the ETT or coughing, could dislodge the biofilm into the airway and increase the risk
of VAP (Moore. 2003; Morehead and Pinto. 2002).
According to Hunter (2012, p.40) "VAP is a hospital acquired pneumonia that occurs 48 hours or
more after tracheal intubation or acute tracheostomisation". VAP is one of the most common
nosocomial infection responsible for one third of mortal respiratory infections in European ICUs
(Adib–Hajbaghery et al. 2011).
Despite of its high incidence, identifying VAP infection requires a

Thesis Statement For Hospital Acquired Illness
Hospital–acquired Illnesses
Purpose: To inform the audience about what a hospital–acquired illness is.
Thesis: Hospital–acquired illnesses, something one may think is uncommon, kills many each year
and is due to hospital neglect.
Introduction
When the word 'hospital' comes to mind, what do you guys think of? You guys have probably all
seen Grey's Anatomy and are aware that hospitals are mostly known for taking care of patients so
they can return to a healthy state. However, what if i said hospitals can be one of the reasons why
people get sick while they are there?
Thesis statement: Hospital–acquired illnesses, something one may think is uncommon, kills many
each year and is due to hospital neglect.
Rather than taking care of patients around the clock, ... Show more content on Helpwriting.net ...
b) More sources.
Pneumonia
A patient can also develop a hospital–acquired illness from not using a ventilator correctly which
leads to pneumonia.
Ventilator–acquired pneumonia
The authors of Current Opinion in Pulmonary Medicine state that "Ventilator–associated pneumonia
(VAP), a subset of HAP that occurs in mechanically ventilated patients more than 48 h after tracheal
intubation"
The type of ventilator that is needed to treat patients is called a mechanical ventilator. For these
ventilators, a tube has to be inserted down the person's throat thus causing more bacterial to get
inside the patient's body.
Conclusion
While most may think that hospitals are an environment for patients to return to their healthy state,
hospitals can also be an environment where it deters them from healing. Hospital–acquired illnesses
kill many each year and is due to reason of neglect or misuse of equipment.
Restate Incorrect use of equipments / Sanitation
Many factors go into hospital acquired illnesses.
All in all, the takeaway is that hospitals have much more to them behind what you may think. It can
be hurting the patient rather than taking care of them. Thank you.

Works

Preventing Ventilator Associated Pneumonia in Children Essay
Preventing Ventilator Associated Pneumonia in Children
Hospitalization for any family is a hard situation to deal with, when it is a child in the hospital the
situation because even tougher to handle. Because of the delicate situation of family members in the
hospital it is imperative that the patient does not obtain any hospital acccuired conditions. One of the
most common hospital acquired infections (HAI) is ventilator–assocaited pneumonia (VAP).
Although it is commonly seen in the hospital setting it can have devastating effects, especially on
children. Prevention of VAP is the goal for critical care nurses in all hospitals.
Although many people have heard of or had pneumonia many people are not aware of what
ventilator associated ... Show more content on Helpwriting.net ...
Younger children are more likely to acuire VAP than adults because of their decrease function of the
immune system.
Dental plaque is a main culprit of causing VAP in young patients. The mouth harbors many bacterias
including gram positive and gram negative bacterias. To prevent ventilator associated pneumonia
from dental plaque guidelines have been set up to decrease the risks. For all infants and children
every two hours the oral cavity should be moistened and the lips should be coated with petroleum
jelly. For children with teeth it is recommended that the teeth be brushed every twelve hours with
fluoride toothpaste, oral cavity suctioning should be done frequently but do not rinse the mouth.
Daily oral care with 0.6% chlorhexidine for children over 6 who have teeth is also indicated.
There are numerous other techniques used to prevent VAP. Like many respiratory problems the head
of the bed should always be elevated to between 30 and 45 degrees to prevent aspiration of fluids
and sputum. The tubing for the ventilator should only be changed on a as needed basis. The
continuous changing of tubes moves the bacteria and can introduce new bacteria into the respiratory
system. Patients should also receive "sedation vacations" and prophylaxis medications to prevent
peptic ulcers. Weaning of the mechanical ventilator should also be done as soon as possible

Research Paper On Pneumonia
Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and
congested and alveolar spaces are filled with fluid and cells–polymorphs and lymphocytes (Mandell
L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing
two million deaths annually among the young and elderly. Pneumonia is the largest killer,
accounting for 28% to 34% of all child deaths below five years of age in low–income countries and
is an important cause of mortality in the elderly in high–income countries (Suárez). There are four
different classifications of pneumonia including community–acquired pneumonia, hospital–acquired
pneumonia, healthcare associated pneumonia, and ventilator–associated event which were
previously referred to as ventilator–associated pneumonia (HESS). Bacteria, fungus, and viruses are
some of the major causes of any type of pneumonia. Specifically, pneumococcus and Haemophilus,
influenza are common pneumonia–causing bacteria. In children, these bacteria are the most present.
Streptococcus pneumonia These microorganisms are capable of causing pneumonia, which is
defined as inflamed air sacs in the lungs capable of developing fluid. According to the Lung
Association if you develop pneumonia, the ... Show more content on Helpwriting.net ...
Another way to prevent pneumonia is to get vaccinated. There are two vaccines that are approved
for adults one is called the pneumococcal conjugate vaccine and the other is called the
pneumococcal polysaccharide vaccine. It is recommended for people over the age of 19 to receive
the conjugate vaccine. The polysaccharide vaccine is recommended for adults 19 to 64 who qualify
for the conjugate vaccine (Hess, pg.866). According to The American Lung Association, getting a
flu shot every year can be one of the best ways to prevent seasonal influenza leading to the
prevention of pneumonia.

Pneumonia: the Silent Killer
Running Head: PNEUMONIA: THE SILENT KILLER Exploring Pneumonia: A Silent Killer
Abstract This paper explores Pneumonia and the respiratory disease process associated with
bacterial and viral pathogens most commonly located in the lung. The paper examines the process,
symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to
educate the reader and to warn of the Exploring Pneumonia: A Silent Killer Pneumonia is an
infection of the lungs. Many different organisms can cause it, including bacteria, viruses, and fungi.
Pneumonia can range from mild to severe, and can even be deadly. The severity depends on the type
of organism causing pneumonia, as well as your age and underlying health. ... Show more content
High–dose amoxicillin or amoxicillin–clavulanate. Many people can be treated at home with
antibiotics. If you have an underlying chronic disease, severe symptoms, or low oxygen levels, you
will likely require hospitalization for intravenous antibiotics and oxygen therapy. Infants and the
elderly are more commonly admitted

Ventilator-Associated Pneumonia
Abstract
Clinical problem: Oral care and ventilator–associated pneumonia (VAP) is extremely important in
all healthcare organizations and has gained increased attention. For this reason, oral care has been
introduced in many hospital settings. However, there is not enough evidence on critically ill patients
concerning the effect of oral care interventions on the development of VAP. In order to evaluate the
effect of oral care on VAP for hospitalized patients, additional studies are required.
Objective: To determine if oral care lowers the incidence rate of hospital acquired pneumonia
infection in hospitalized patients with ventilators.
The purpose of this paper is to assess the effects of oral care on ventilator–associated pneumonia for
inpatient ... Show more content on Helpwriting.net ...
The rate of development of VAP was significantly higher in the control group (68.8%) compared to
the CHX group (41.4%) [p = 0.03] : [odds ratio = 3.12 95% CI =

Community Acquired Pneumonia Essay
Pneumonia is an acute infection of the lungs, it can be caused by a variety of organisms entering the
body – including bacteria, viruses or fungi. The infection causes an inflammation of the alveoli (air
sacs) of the lungs and may result in the alveoli filling with fluid or other purulent material (Mayo
Clinic, 2016). An accumulation of fluid within alveoli and portions of the lungs, can reduce the
ability of the lungs to allow for oxygen diffusion across the alveoli walls. If oxygen saturation is
low, it can cause the body's cells to not work effectively. Therefore, the risk of the infection
spreading through the body is increased – it is due to this reason, that pneumonia can be life–
threatening (American Lung Foundation, 2016). Pneumonia ... Show more content on
Helpwriting.net ...
Pneumonia is classified according to the organism causing the infection and where the infection was
acquired. Community–acquired pneumonia is contracted by individuals with minimal contact with
health care facilities – such as a hospital, nursing home, or rehabilitation facility – and contract the
infection by people in the wider community (MedlinePlus, 2016). Hospital–acquired pneumonia and
ventilator assisted pneumonia, can be caused by a wide variety of bacteria and other organisms that
can originate from the health care environment (Oxford Journals, 2016). Pneumonia that develops
whilst an individual is in hospital, can be extremely severe and is more likely to be fatal. This is due
to the fact, that individuals within a health care setting, often already have a serious illness, causing
a weakened immune system. Also, the types of bacteria present in hospitals, are often more
dangerous and resistant to treatment – then the bacteria found in the outside community
(MedlinePlus, 2016). Aspiration pneumonia – or anaerobic pneumonia – results after the inhalation
of a foreign matter into the lungs. If foods, liquids, saliva, or vomit make their way into the airways
or lungs, instead of the oesophagus and stomach, it can cause aspiration pneumonia. It is more likely
in individuals with a disturbed gag reflex – commonly due to having a brain injury or being under
the influence of drugs or anaesthetics (MedlinePlus,

Essay on Health Associated Infections
Hospital acquired infections are one of the most common complications of care in the hospital
setting. Hospital acquired infections are infections that patients acquired during the stay in the
hospital. These infections can cause an increase number of days the patients stay in the hospital.
Hospital acquired infections makes the patients worse or even causes death. "In the USA alone,
hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year"
(secondary).
Nursing diagnosis
Hospital acquired infections are spread by numerous routes including contact, intravenous routes,
air, water, oral routes, and through surgery. The most common types of infections in hospitals
include urinary tract infections (32%), ... Show more content on Helpwriting.net ...
After microorganisms enter the patient's body they can go to the lungs and cause pneumonia.
Central line–bloodstream infections occur when microorganism enter the bloodstream by the
intravenous line. Microorganisms are transfer into the blood stream by inadequate hand hygiene or
improper intravenous fluid, tubing, and site care practice. Multidrug–resistant organisms can cause
infections of the blood, skin, or organ systems. These infections can arise due to the overuse or
misuse of antibiotics, which can result in the microorganisms becoming more resistant to antibiotic
therapy. Methicillin–resistant Staphyloccocus aureus and Clostridium difficile are examples of this
kind of infection. Health care employees need to know the different types of hospital acquired
infections and how they are spread to be able to effectively prevent them. The priority nursing
diagnosis of hospital acquired infection is risk for any kind of infection. One of the main goals for
each patient in the hospital is the patient will remain free of infection as evidence by absence of
heat, pain, redness, or swelling in any area of the patient's body during each nurse's shift. (care plan
book). Frequently hand washing is the best intervention for preventing infection. Hand washing
reduces the risk of transmission of pathogens by inhibiting the growth of or killing the
microorganisms. (cb)Proper sterile technique during urinary

Maintaining Oral Hygiene Is A Essential Element Of...
Maintaining oral hygiene is a vital element of preventing hospital acquired pneumonia (HAP), many
facilities do not have a specific policy in regards to oral care, if policies are in place, and practices
are usually inconsistent. For patients that are intubated, endotracheal tube placement delivers a
straight pathway for bacteria to enter the body. Ventilator–associated pneumonia (VAP) is a serious
danger to patients who are on mechanical ventilation. Oral care is a nursing intervention that reduces
the incidence of HAP and VAP. Oral care practices and policies vary from hospital to hospital, and
may be inconsistent and difficult for nurses to follow. It is essential that nurses, certified nursing
assistants, or patient care technicians ... Show more content on Helpwriting.net ...
To describe the purpose of oral care and a process for performing oral care for intubated and non–
intubated patients. Oral Health has been identified as one of five key elements by the Institute for
Healthcare Improvement (IHI) to help prevent ventilator associated pneumonia
II. Policy:
It is the policy of ABC Hospital that:
A. Assessment
Should be performed initially by a registered nurse, and once a shift for conscious and unconscious
patients and to gage the level of oral abnormality and provide the utmost applicable care to warrant
that the patient is comfortable and prevent complications.
For intubated patients initial oral assessment should be done upon admission by a registered nurse
and every 8 hours to document any changes in the patient's oral health.
Intubated patients need to be assessed to determine the need for suction, deflation of the
endotracheal cuff and repositioning of endotracheal tube.
B. Brushing a patient's teeth should occur on once every shift and as frequent as needed (PRN) to
prevent the development of plaque. This task can be performed by a registered nurse or a certified
nursing assistant for conscious patients Chlorhexidine Gluconate (CHG) 0.12% oral rinse swabs will
be used on intubated patients. Alcohol–free, antiseptic oral rinse should be used for conscious
patients to prevent colonization of bacteria.
C. For patients undergoing surgery Chlorhexidine Gluconate (CHG) 0.12% oral rinse should be

Community Acquired Pneumonia Research Paper
Pneumonia
Pneumonia is a curable disease. What is pneumonia? Pneumonia is an infection of the lungs. It can
be in one or both of them at the same time. It causes inflammation to form in the air sacs causing
fluid in them and makes it very difficult to breath. (http://healthline.com/pneumonia)
According to "Pneumonia History" pneumonia is a worldwide disease caused by an infection of the
lungs producing coughing, fever, chills , muscle aches, and difficulty in breathing for those who
suffer it (http://www.news–medical.net/health/Pneumonia–History.aspx). Pneumonia was first
described by the Greek physician Hippocrates around 460 B.C. In 1875, German pathologist Edwin
Kelbs observed pneumonia bacteria under a microscope for the first ... Show more content on
Helpwriting.net ...
The goals of treatment are to cure the infection and prevent complications. Most people can be
treated at home by following these simple steps. You must drink plenty of fluids. This will help
loosen up the phlegm and you will be able to cough it up. You must get plenty of rest. Take the
lowest dose of cough medicines that you can. You must control your fever. It is always important to
take your antibiotics when you are suppose to.
They are used to treat bacterial pneumonia after it is decided the type that is causing it.
If you do not get better the doctor may have to change the medicine. Cough medicines are used to
control your coughing. This way you are able to rest some. The reason your body makes you cough
is to get the fluid loose in your lungs so it can be removed. This is a necessary thing that must
happen for you to get better. Fever and pain reducers can be taken as needed to make you more
comfortable during your recovery. There are sometimes when people have to be admitted to the
hospital before they will get better. Some reasons may be if you are having trouble breathing, high
or low temperature, you are confused or having high blood pressure. These are serious problems that
only a hospital will be able to help you with. Children are also at a great risk for the same problems.
If someone is admitted to the hospital, they will

Epidemiology Of Pneumonia
Pneumonia is defined as an acute infection of the pulmonary parenchyma. It is associated with at
least some symptoms of acute infection, a new infiltrate or auscultatory findings such as altered
breath sounds (Infectious Diseases Society of America 2000). It is a prevalent condition that carries
a high incidence of mortality and morbidity, particularly in the very young or old populations.
Pneumonia outcomes vary from without any incidence, to a hospital admission, and could even lead
to death. The CDC data from 2013, pneumonia is the 8th leading cause of death in the United States.
Though antibiotics have reduced the mortality rate of pneumonia, the CDC reported a rise in
pneumonia from 2012–2013(CDC, 2013). The data in combination with the ... Show more content
The usage of antibiotics as a method of treating pneumonia can be supported by a publication
authored by Awad et al. (2014). The double blind randomized study was performed to compare the
effectiveness of Ceftobiprole medocaril against Ceftazidime plus linezolid in the treatment of
hospital–attained pneumonia. According to the results of the research, it was determined that
Ceftobiprole is an effective as well as safe antibiotic that can be employed in the treatment HAP
(Hospital acquired pneumonia). The results also showed that the antibiotic cannot be used as an
effective remedy for VAP (Ventilator Assisted

Ventilater Associated Pneumonia
i VENTILATOR ASSOCIATED PNEUMONIA: EDUCATION AND PREVENTION A
RESEARCH PAPER SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL
FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE MASTER OF SCIENCE BY
MEGHAN CROCKETT BSN, RN, CMSRN DR. NAGIAALI – ADVISOR BALL STATE
UNIVERSITY MUNCIE, IN DECEMBER 2011 Table of Contents Table of
Contents.......................................................................................i
Abstract................................................................................................iii Chapter
I.................................................................................................1
Introduction...................................................................................1 Background and
Significance...............................................................3 Problem
Statement...........................................................................5
Purpose........................................................................................5 Research
Questions..........................................................................5 Conceptual Theoretical ... Show more
VAP is a growing problem in health care facilities which increases the cost of patient care and
increases patient–care time, hospital length of stay, and patient morbidity. Ventilator–associated
pneumonia increases healthcare costs by more than $40,000 per hospitalized patient (Lisboa, Kollef,
& Rello, 2008). Centers for Medicare and Medicaid Services plan to stop paying hospitals for
necessary care caused by preventable complications including nosocomial infections resulting in
unintended fiscal circumstances (Lisboa et al.). 2 The Centers for Disease Control (CDC)
established recommended guidelines to decrease the risk of VAP. It is these best practice
interventions that nurses should follow when caring for mechanically ventilated patients. The 2003
CDC guidelines reported that 63% of admitted patients in the ICU have oral colonization associated
with a pathogen resulting from VAP (Cason, Tyner, Saunders, & Broome, 2007). The CDC provided
a set of seven guidelines to reduce risks related to hand washing, wearing gloves, suctioning,
elevated head of bed (HOB), education, oral hygiene program, and use of antiseptic rinse. Studies
suggested that best practices for reducing VAP were not consistently implemented. According to the
Centers for Disease Control, Pseudomonas aeruginosa and gram positive Staphylococcus aureus
were the two most common bacteria linked to VAP (Babcock et al., 2004). Pseudomonas

Symptoms And Symptoms Of Pneumonia
Introduction: Pneumonia is the leading infectious cause of death in children and the fourth leading
cause of death in the elderly worldwide.1,2 Although pneumonia is a common disease, it rarely
affects healthy individuals. This condition affects people of all ages, however it is most dangerous in
immunocompromised individuals such as children, infants, and older adults.1 Other populations that
are vulnerable are those who are bedridden, inactive, or immobile; those with altered consciousness;
those who have difficulty swallowing; and those who have impaired cough reflexes.1 Risk factors
for pneumonia include cigarette smoking, acute respiratory infections, chronic bronchitis,
uncontrolled diabetes mellitus, uremia, dehydration, ... Show more content on Helpwriting.net ...
Pathophysiology: In a normal, healthy lung, air travels through a highway of airways, called
bronchioles, to eventually reach tiny air sacs, called alveoli, the site of gas exchange with the blood
capillaries.1 The right and left lungs are separated by fissures into lobes and are further divided into
segments and then into lobules, which contain the alveoli.1 In pneumonia, a common inflammatory
and infectious disease of the lung, fluid accumulates within the alveoli and/or the lobe, which
reduces the surface area exposed to air making it difficult to breath.3 Typically, the body is able to
filter out germs that invade the respiratory system by using defense mechanisms such as the immune
system, the structure of the nose and throat, coughing, and cilia; however, some germs are able to
reach the lungs to cause infection, especially in those who are immunocompromised.3 For example,
someone who is in a medically–induced coma due to a stroke, is unable to cough, and as a result, the
germs remain in the airway. Once the germs enter the lungs, the immune system responds by
attacking.3 This causes the alveoli to inflame, turn red, and fill up with fluid and pus, which are the
symptoms of pneumonia.3 There are three common bacteria that cause pneumonia – Streptococcus
pneumonia, Legionella pneumophilia, and Mycoplasma pneumonia.3 Streptococcus pneumoniae or
pneumococcus are the most common

A Research Proposal Investigating How Nursing Home...
A Research Proposal Investigating How Nursing–Home Acquired Can be Preventable through
Practice Improvement Student's Name University Affiliation Date Abstract Pneumonia is a
significant factor that leads to morbidity as well as mortality in nursing home residents. It has a one–
month mortality rate that range from 15–35%. Nursing home residents are frequently referred to
hospitals for diagnostic tests. They may as well be provided with acute health care services. In our
qualitative study, we shall examine residents and family members' perspective on pneumonia
prevention. The study design that we shall use is qualitative descriptive in nature. The subjects will
be residents and relatives who have received pneumonia treatment. We shall derive them from a
randomized controlled trial. In total, we shall conduct 15 in–depth interviews. We shall then analyze
the collected data editing style. The style was described by Crabtree to establish important themes.
Both residents and relatives prefer pneumonia treatment to take place in nursing homes where
applicable. Caring and attention crucial during provision of care and they can only be attained in a
nursing home context. Interventions to control hospitalizations of nursing home residents suffering
from pneumonia are congruent to residents and relative preferences. Introduction Nursing home–
acquired pneumonia is normally bacterial in origin. Streptococcus pneumonia is the frequent
causative agent. Nevertheless, in adverse

Hospital Acquired Pneumonia Essay
Pneumonia is an infection of the pulmonary parenchyma. Earlier, pneumonia was typically
classified as community–acquired (CAP), hospital–acquired (HAP), or ventilator–associated (VAP).
As a result of widespread use of potent oral antibiotics, earlier transfer of patients out of acute–care
hospitals to their homes or various lower–acuity facilities, increased use of outpatient IV antibiotic
therapy, general ageing of the population, and more extensive immunomodulatory therapies, over
the past two decades some patients are found to be infected with the multidrug–resistant (MDR)
pathogens that were previously associated with HAP.12 Health care associated pneumonia is defined
as pneumonia that occurs in a non hospitalized patient with extensive healthcare contact, as defined
by one or more ... Show more content on Helpwriting.net ...
Hospital acquired pneumonia ( HAP) is defined as pneumonia acquired after 48 hours of hospital
stay in patients who are not on ventilatory support.14 Ventilator associated pneumonia( VAP) is
defined as pneumonia occurring after 48 hours of prolonged mechanical ventillation14 Community
acquired pneumonia is defined as pneumonia acquired outside a hospital or long–term care facility.
It occurs within 48 hours of hospital admission or in a patient presenting with pneumonia, who does
not have any of the characteristics of healthcare–associated pneumonia (i.e., hospitalized in an acute
care setting for 2 or more days within 90 days of infection; resided in a nursing home or long–term
care facility; received recent intravenous antibiotic therapy, chemotherapy, or wound care within the
past 30 days of the current infection; or attended a hospital or haemodialysis clinic).15,

Ventilator Associated Pneumonia Essay
Ventilator–associated pneumonia is the leading cause of death out of all hospital–acquired
infections. Pneumonia that is acquired 48 hours or longer after at patient has been mechanically
ventilated is considered hospital acquired. Endotracheal tubes provide pathogenic microorganisms'
with a direct access to the lungs where they can easily set up shop and cause deathly consequences
for patients' in the acute care setting. For example, the mortality rate of patients who have
ventilator–associated pneumonia is 46% whereas unaffected intubated patients mortality rate is
32%. When ventilator–associated pneumonia (VAP) occurs in a patient(s), it often increases the
amount of days a patient is on the ventilator and increases their overall hospital stay (Safe Care).
The big problem with this is that VAP is costing hospitals ... Show more content on Helpwriting.net
...
This includes elevating the head of the bed at least 30 degrees, preventing aspiration, turning and
positioning, and most importantly, performing oral care. A major source of VAP is the aspiration of
microorganisms from the mouth, proving oral hygiene for mechanically ventilated patients is of top
priority. Although, methods and timing of oral care varies widely between facilities, for instance,
some hospitals may brush teeth with a tooth brush while others may use a sponge swab. A common
oral care protocol is usually brushing teeth every 8 hours and using an antimicrobial rinse
(chlorhexidine) every 2 hours (Ignatavicius & Workman, 2013). It should be noted that quality
education on the link between poor oral hygiene and ventilator–associated pneumonia should be
provided to licensed nurses as well as nurses' aides that would be responsible for providing oral
care. Understanding the importance of being vigilant at providing oral care may further reduce VAP
occurrences due to increased compliance and efficiency of oral care

Problems Associated With Urinary Tract Infections
In order to reduce Hospital Readmissions and Hospital Acquired Conditions financial resources
need to be managed carefully, as leaders we have to understand that by investing in nursing training
and in departments like Infection Control we will save money at the and most important we will
provide better care to our patients.
In our hospital the Vascular Access team came up with the initiative of creating the "PICC Police",
they not only monitor the timely dressing change of their lines and competence of nurses but also
educate patients and family on how nurses should perform the procedures, on signs and symptoms
of infection and on how to contact the Vascular Access team if they have any question or concern.
By educating and involving the patients and caregivers on their care nurses are force to perform by
the book and a 46% decrease in CLABSIs has occurred.
Among Urinary Tract Infections (UTI) acquired in the hospital, approximately 75% are associated
with a urinary catheter. Between 15–25% of hospitalized patients receive urinary catheters during
their hospital stay (as per Center for Disease Control and Prevention), the most important risk factor
for developing a catheter–associated UTI (CAUTI) is prolonged use of the urinary catheter.
Therefore, in our hospital every unit conduct a daily huddle, one of the topics is urinary catheters
appropriate indications and how soon they can be removed. The Certified Nursing Assistant 's
patient ratio was reduce in order to

Evaluation Of Using A Protocol Adoption Of A Bundle Care...
A timeframe of about 6–month test of pilot will be completed to test the feasibility and efficacy of a
protocol adoption of a bundle care for the prevention of ventilator associated pneumonia. The VAP
bundle protocol guidelines will be used to determine quality management and reflective data audit
for all patients admitted in the intensive care unit with mechanical intubation within this 6–month
trial period. Evaluation is a systematic way of checking a project's information on the activities, and
characteristics in order to make a judgement of the project. Evaluation can help to give
recommendations to the project and improve by adapting the recommendations and improve future
projects. Evaluation gives managers considerable evidence to support the decision process with the
well documented analysis. Described methods used to evaluate effectiveness of proposed solution.
In order to attain excellence in patient care, latest evidence to support care is necessary, and the
outcomes of the care in nursing should show aspects of the process change (Frisch & Kelley, 2002).
The purpose of an evaluation is to see if there is compliance with the intended change and measure
the impact of the process change. When doing evaluation it is important to engage the key
stakeholders in the process. In addition, working with the stakeholders to ensure that the training
objectives align with the business needs if of far great importance. Expectations of the training
should also be in agreement

Case Study Of Pneumonia And Chronic Pulmonary Disease

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