Decreasing
Ventilator-Associated Pneumonia:
Evidence-Based Practice at the Bedside
Susan
F. Dukes, MS, MA, CCRN, CCNS, ACNP
Critical Care Nurse
Theresa L. Dremsa, PhD
Director of Nursing Research
United States Air Force
Intent
Apply an Evidence-Based
Practice Model to Selected Critical Care Units at Wilford
Hall Medical Center (WHMC) to Move Research to the Bedside.
Problem
Despite initial education measures, ventilator associated
pneumonia rates were not improving within the Surgical Intensive
Care Unit.
Evidence
Using external resources,
an evidence synthesis was conducted, and graded evidence
to guide practice was applied to enhance expertise in the
critical care units. An interdisciplinary team evaluated
the evidence provided and developed an implementation plan.
Strategy
Utilize evidence base
practice process and clinical experts to evaluate current
practice and develop evidence-based initiatives and assure
implementation of these practices to ultimately decrease
ventilator associated pneumonia rates and related consequences
thereby improving patient outcomes.
Practice change
Assessing current
level of knowledge and compliance with identified care initiatives
though identification of barriers and facilitators of desired
behaviors A clinical Practice Guideline and policy for clinical
management of Ventilator-Associated Pneumonia (VAP) is under
development. There will be ongoing education and assessment
of compliance to verify change in practice at the bedside.
Evaluation
Evaluation of the
impact of the change will be patient outcomes and staff
compliance rates.
Recommendations
Use this systematic
process as a template for development of other clinical
practice guidelines.
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