CRITICAL CARE CLINICIANS KNOWLEDGE GUIDELINES FOR PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA OF EVIDENCE-BASED. C E 1.0 Hour. Pulmonary Critical Care
|
|
- Delphia Greer
- 6 years ago
- Views:
Transcription
1 Pulmonary Critical Care CRITICAL CARE CLINICIANS KNOWLEDGE OF EVIDENCE-BASED GUIDELINES FOR PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA By Mohamad F. El-Khatib, MB, PhD, Salah Zeineldine, MD, Chakib Ayoub, MD, MBA, Ahmad Husari, MD, Pierre K. Bou-Khalil, MD C E 1. Hour Notice to CE enrollees: A closed-book, multiple-choice examination following this article tests your under standing of the following objectives: 1. Identify evidence-based guidelines for preventing ventilator-associated pneumonia. 2. Identify 2 knowledge deficits of participants in this research study.. Discuss the results of this research study and the implications for critical care nursing. To read this article and take the CE test online, visit and click CE Articles in This Issue. No CE test fee for AACN members. 29 American Association of Critical-Care Nurses doi: 1.4/ajcc29 Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended. Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia. Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia. Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 8.2% (.4%), 8.1% (1.6%), and 8.% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than years of intensive care experience did not differ significantly from the scores of professionals with more than years of intensive care experience. Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia. (American Journal of Critical Care. 21;19:22-2) 22 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 21, Volume 19, No.
2 Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection among patients who receive mechanical ventilation in the intensive care unit (ICU). 1,2 VAP is associated with delayed extubation, prolonged stays in the ICU and hospital, increased mortality and morbidity, and increased use of health care resources.,4 As such, prevention of VAP is an essential objective of health care delivery in ICUs. Many strategies and guidelines have been developed and proposed for the prevention of VAP. - Adherence to and implementation of the adopted VAP prevention guidelines have been variable 8,9 and were affected by lack of training, lack of an adequate infection control program, and lack of knowledge among health care providers of such guidelines. 1, Although knowledge of the guidelines does not guarantee implementation and adherence, lack of knowledge may be a barrier to adherence to and implementation of VAP prevention guidelines. Many studies have focused on assessing the knowledge of ICU nurses regarding measures for the prevention of VAP. 9-1 Other ICU health care providers particularly respiratory therapists, who are involved in controlling endotracheal cuff pressure, avoiding microaspiration of subglottic secretions, and controlling contamination of mechanical ventilator equipment can have a significant effect on the prevention of VAP in patients receiving mechanical ventilation in the ICU. 14 The aim of this study was to assess the knowledge of ICU health care providers (ie, physicians, nurses, and respiratory therapists) related to evidence-based guidelines for prevention of VAP. Methods A multiple-choice questionnaire consisting of 9 items (Table 1) that had been developed, validated, and tested by Blot et al 12 and Labeau et al 1 was distributed to all physicians, nurses, and respiratory therapists working in the ICU of a 42-bed university hospital. The ICU had 2 beds with an approximate daily average of 12 patients receiving mechanical ventilation. Any staff member who was About the Authors Mohamad F. El-Khatib is a professor and Chakib Ayoub is an associate professor in the Department of Anesthesiology and Salah Zeineldine, Ahmad Husari, and Pierre K. Bou-Khalil are assistant professors in the Department of Medicine in the School of Medicine at the American University of Beirut, Beirut, Lebanon. Corresponding author: Dr Pierre Bou-Khalil, Assistant Professor, Division of Pulmonary and Critical Care, Department of Internal Medicine, American University of Beirut, PO Box -26, Beirut, Lebanon ( pb@aub.edu.lb). aware of the previous 2 studies by Blot et al 12 and Labeau et al 1 was not allowed to participate in the study; such exclusion was intended to eliminate any potential bias in the answers of participants. Knowledge of the recently published articles was determined by a direct question to the participant. Additional demographic information obtained in the survey included the participant s professional category, sex, and years of ICU experience. Data were collected from June 1 to June 1, 28. During this period, one of the investigators (M.F.K.) distributed the questionnaire by hand to all critical care physicians, ICU nurses, and respiratory therapists. Eligible participants were given 1 minutes to complete the questionnaire, similar to previous studies. 12,1 For each item of the questionnaire, the percentage of correct answers was determined, then mean total scores were calculated. All data were compared among the categories of health care professionals. Continuous data are presented as means and standard deviations and were compared with analysis of variance and Scheffe test for post hoc analysis. The χ 2 test was used to compare percentages of correct answers. Linear regression analysis was used to assess the relationship between scores and participants demographic characteristics. SPSS for Windows 1. (SPSS, Chicago, Illinois) was used for statistical analysis. Statistical significance was set at P <.. Results All 1 critical care physicians (1%), 41 of the 4 ICU nurses (8%), and all 18 respiratory therapists (1%) who were given the questionnaire completed it (Table 2). In the physician category, % were men and % were women, and their mean ICU Knowledge of VAP guidelines was compared among nurses, physicians, and respiratory therapists. AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 21, Volume 19, No. 2
3 Table 1 Scores (%) by each category Physicians (n = 1) Nurses (n = 41) Scores, % Respiratory therapists (n = 18) 1. Oral vs nasal route for endotracheal intubation a. Oral intubation is recommended b. Nasal intubation is recommended c. Both routes of intubation can be recommended 2. Frequency of ventilator circuit changes a. Recommended to change circuits every 48 h (or when clinically indicated) b. Recommended to change circuits every week (or when clinically indicated) c. Recommended to change circuits for every new patient (or when clinically indicated). Type of airway humidifier a. Heated humidifiers are recommended b. Heat and moisture exchangers are recommended c. Both types of humidifiers can be recommended 4. Frequency of humidifier changes a. Recommended to change humidifiers every 48 h (or when clinically indicated) b. Recommended to change humidifiers every 2 h (or when clinically indicated) c. Recommended to change humidifiers every week (or when clinically indicated). Open vs closed suction systems a. Open suction systems are recommended b. Closed suction systems are recommended c. Both systems can be recommended 6. Frequency of change in suction systems a. Daily changes are recommended (or when clinically indicated) b. Weekly changes are recommended (or when clinically indicated) c. Recommended to change systems for every new patient (or when clinically indicated). Endotracheal tubes with extra lumen for drainage of subglottic secretions a. These endotracheal tubes reduce the risk for VAP b. These endotracheal tubes increase the risk for VAP c. These endotracheal tubes do not influence the risk for VAP 8. Kinetic vs standard beds a. Kinetic beds increase the risk for VAP b. Kinetic beds reduce the risk for VAP c. The use of kinetic beds does not influence the risk for VAP 9. Patient positioning a. Supine positioning is recommended b. Semirecumbent positioning is recommended c. The position of the patient does not influence the risk for VAP Total score, mean (SD) (.4) (1.6) (6.) Abbreviation: VAP, ventilator-associated pneumonia. a The correct answers are indicated by the circled letters. experience was.8 (SD, 6.) years. The nursing category consisted of % men and 6% women with a mean ICU experience of 6.8 (SD, 1.4) years. Among the group of respiratory therapists, 9% were men and % were women, with a mean ICU experience of 8. (SD, 6.6) years. The mean years of 24 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 21, Volume 19, No.
4 experience did not differ significantly among the categories of participants. The questionnaire and the answers of the health care professional categories are presented in Table 1. Correct answers are indicated by a circle. Mean scores for ICU physicians, nurses, and respiratory therapists were 8.2% (SD,.4%), 8.1% (SD, 1.6), and 8.% (SD, 6.%), respectively, with no significant differences among groups. The results indicate that the participants were most frequently correct about using an endotracheal tube with a larger lumen than usual for drainage of subglottic secretions (question ) and about using open versus closed suction systems (question ). Respondents had the least knowledge about the frequency of humidifier changes (question 4) and the optimal frequency of ventilator circuit changes (question 2). No significant differences were found between male and female participants. When stratified on the basis of the numbers of years of ICU experience (ie, years vs > years), the total scores did not differ significantly between health care professionals with more than years of ICU experience and professionals with years or less of ICU experience (Table ). Discussion We found no differences in the knowledge of guidelines for the prevention of VAP among the physicians, nurses, and respiratory therapists working in the ICU. Knowledge of established measures for the prevention of VAP among nurses has been reported. -1 However, previous studies were focused exclusively on critical care nurses, whereas we compared the knowledge of other health care professionals (physicians and respiratory therapists) as well as nurses, because all of them are involved in providing direct care for patients receiving mechanical ventilation in the ICU. The nurses in our study outperformed nurses from other studies with regard to their knowledge of evidence-based guidelines for preventing VAP. In our study, the nurses mean total score of correct answers to the VAP questionnaire was 8.1%, whereas Blot et al 12 reported a mean score of 41.2% when they surveyed 68 intensive care nurses during the annual congress of the Flemish Society of Critical Care Nurses in 2. One possible explanation of this difference is the fact that the model of health care delivery in ICUs in Lebanon includes respiratory therapists, a category of health care professional not used in the European countries where knowledge of VAP prevention practices has been studied before. Respiratory therapists play an integral role in the management of patients receiving Table 2 Participants demographics Characteristic Sex Male Female Years of experience in intensive care unit < >1 Mean (SD) Physicians (n = 1) mechanical ventilation in the ICU and provide respiratory care services (eg, oral intubation, use of endotracheal tubes with subglottic suctioning to avoid microaspiration, control of endotracheal tube cuff pressure, change of ventilator circuits) that may result in lower rates of VAP. Perhaps the respiratory therapists, ICU nurses, and physicians discussed the evidence-based guidelines for prevention of VAP during daily medical rounds, performance improvement meetings, and educational activities (eg, VAP day). Previously, Labeau and colleagues 1 reported lower scores for ICU nurses on knowledge of VAP prevention guidelines than the scores reported here. They acknowledged that ICU nurses in Belgium and elsewhere in Europe manage many strategies related to the prevention of VAP, such as ventilator circuit and humidifier changes, on top of their regular nursing duties. Blot et al 12 previously reported that more experienced nurses have a higher knowledge level than do nurses with less than 1 year of experience. Our study shows that adequate knowledge of the nonpharmacological guidelines for the prevention of VAP can be gained within the first years of ICU experience. Although we originally planned to use a lower cutoff for the number of years of ICU (6.) Table Scores according to participants years of experience in intensive care Years of experience > Physicians 8.2 (12.8) 8.2 (8.2) No. of participants Nurses (n = 41) (1.4) Score, mean (SD) Nurses 6.2 (9.) 81.9 (6.9) Respiratory therapists (n = 18) (6.6) Respiratory therapists 81. (6.) 8.2 (6.2) Knowledge did not differ among groups or differ depending on ICU experience. AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 21, Volume 19, No. 2
5 These nurses outperformed nurses from other studies in knowledge of VAP guidelines. Knowledge of recommended guidelines does not necessarily reflect appropriate practice. experience, unfortunately we did not have enough participants with less than 1 year of ICU experience to be able to perform that analysis. In the current study, the lowest score achieved by all participants categories was on the question of frequency of airway humidifier changes. Only 26% of the nurses, % of the physicians, and 4% of the respiratory therapists were aware of the recommendation to change airway humidification systems weekly or when clinically indicated. This low score might be influenced by the clinical practice of the respiratory therapists who are in charge of managing these systems and who may be influenced by manufacturers recommendations to change heat and moisture exchange filters every 48 hours. Although our study has the advantage of including all health care professionals in the ICU, it has several limitations. The number of participants in this survey is smaller than in previous, similar studies. The use of a single tertiary care university hospital limits the generalizability of our findings. Also, although we excluded potential participants who might have read one or more of the previously published studies involving the survey used here, participants may still have had previous, knowledge of the survey. Also, by excluding them, we may have inadvertently excluded those professionals with more knowledge about VAP guidelines, so the actual knowledge level of the staff might be higher than what is reflected in these findings. Conclusion Knowledge of recommended guidelines does not necessarily reflect appropriate practice, but knowledge remains the first step toward the implementation of evidence-based guidelines for the prevention of VAP. Our study was intended to assess ICU health care providers (physicians, nurses, and respiratory therapists) knowledge of evidence-based guidelines for preventing VAP and not to evaluate the application and practice of evidence-based guidelines for preventing VAP. Such an evaluation is the next logical step for future study. Based on our analysis of these survey results, we conclude that an ICU health care delivery model that includes ICU physicians, nurses, and respiratory therapists can result in an adequate level of knowledge of the evidence-based nonpharmacological guidelines for the prevention of VAP. ACKNOWLEDGMENTS We thank all who participated in this study. FINANCIAL DISCLOSURES None reported. eletters Now that you ve read the article, create or contribute to an online discussion on this topic. Visit and click Respond to This Article in either the full-text or PDF view of the article. References 1. Chaster J, Fagon J. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 22;6: Depuydt P, Myny D, Blot S. Nosocomial pneumonia: aetiology, diagnosis and treatment. Curr Opin Pulm Med. 26; 12: Rello J, Ollendorf D, Oster G, et al. Epidemiology and outcomes of ventilator associated pneumonia in a large US database. Chest. 22;122: Safdar N, Dezfulian C, Collard H, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systemic review. Crit Care Med. 2;: Tolentino-DelosReyes A, Ruppert S, Shiao S. Evidence-based practice: use of the ventilator bundle to prevent ventilatorassociated pneumonia. Am J Crit Care. 2;16(1): Muscedere J, Dodek P, Keenan S, Fowler R, Cook D, Heyland D. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention. J Crit Care. 28;2: Sinuff T, Muscedere J, Cook D, Dodek P, Heyland D. Ventilator-associated pneumonia: improving outcomes through guidelines implementation. J Crit Care. 28;2: Heyland D, Cook D, Dodek P. Prevention of ventilator-associated pneumonia: current practice in Canadian critical care units. J Crit Care. 22;1: Ricat M, Lorente C, Diaz E, Kollef, Rello J. Nursing adherence with evidence-based guidelines for preventing ventilator-associated pneumonia. Crit Care Med. 2;1: Sierra R, Benitez E, Leon C, Rello J. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish CCUs. Chest. 2; 128: Biancofiore G, Barsotti E, Catalane V, et al. Nurses knowledge and application of evidenced-based guidelines for preventing ventilator-associated pneumonia. Minerva Anesthesiol. 2;: Blot S, Labeau S, Vandijck D, Van Aken P, Claes B. Evidencebased guidelines for the prevention of ventilator-associated pneumonia: results of a knowledge test among intensive care nurses. Intensive Care Med. 2;: Labeau S, Vandijck D, Claes B, Van Aken P, Blot S. Critical care nurses knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia: development and validation of an evaluation questionnaire. Am J Crit Care. 2;16: Kaynar A, Mathew J, Hudlin M, et al. Attitudes of respiratory therapists and nurses about measures to prevent ventilator-asociated pneumonia: a multicenter, cross-sectional survey study. Respir Care. 2;2: To purchase electronic or print reprints, contact The InnoVision Group, Columbia, Aliso Viejo, CA Phone, (8) or (949) 62-2 (ext 2); fax, (949) ; , reprints@aacn.org. 26 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 21, Volume 19, No.
6 CE Test Test ID A9: Critical Care Clinicians Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia. Learning objectives: 1. Identify evidence-based guidelines for preventing ventilator-associated pneumonia. 2. Identify 2 knowledge deficits of participants in this research study.. Discuss the results of this research study and the implications for critical care nursing. 1. Which the following numbers of evidence-based guidelines for preventing ventilator - associated pneumonia (VAP) was included in the knowledge assessment? a. c. 9 b. d. 2. Which of the following methods was used for data collection in this study? a. Questionnaire c. Medical record b. Observation d. Interview. Statistical signif icance in this study was set at which of the following levels? a. P <.1 c. P <.1 b. P <. d. P <. 4. Which of the following numbers of clinicians participated in this study? a. 41 c. 69 b. 4 d.. Evidence-based guidelines for preventing VAP recommend changing ventilator circuits how frequently? a. Every 48 hours c. Every week b. Every 2 hours d. Every new patient 6. Evidence-based guidelines for preventing VAP recommend the use of which of the following airway humidif iers? a. Heated humidifiers b. Cooled humidifiers c. Heat and moisture exchangers d. Cold and moisture exchangers. Which of the following percentages of nurses was aware of the recommendation to change airway humidif iers every week or when clinically indicated? a. 26% c. % b. 4% d. 69% 8. Which of the following percentages of nurses was aware that endotracheal tubes for drainage of subglottic secretions reduced the risk for VAP? a. 41% c. 8% b. 6% d. 9% 9. Which of the following was the mean total test score for nurses? a..% c. 8.2% b. 8.1% d. 8.% 1. Study participants had the most knowledge about which of the following evidence-based guidelines for preventing VAP? a. Endotracheal tubes for drainage of subglottic secretions b. Frequency of airway humidifier changes c. Route for endotracheal intubation d. Frequency of ventilator circuit changes. Study participants had the least knowledge about which of the following evidence-based guidelines for preventing VAP? a. Type of airway humidifier b. Frequency of ventilator circuit changes c. Route for endotracheal intubation d. Frequency of change in suction systems Test ID: A9 Contact hours: 1. Form expires: May 1, 212. Test Answers: Mark only one box for your answer to each question. You may photocopy this form. 1. a 2. a. a 4. a. a 6. a Fee: AACN members, $; nonmembers, $1 Passing score: 8 Correct (%) Synergy CERP: Category A Test writer: John P. Harper, MSN, RN-BC Program evaluation Name Member # Yes No Objective 1 was met Address Objective 2 was met Objective was met City State ZIP Content was relevant to my Country Phone address For faster processing, take nursing practice this CE test online at My expectations were met RN License #1 State ( CE This method of CE is effective RN License #2 State Articles in This Issue ) or for this content mail this entire page to: The level of difficulty of this test was: Payment by: Visa M/C AMEX Check easy medium difficult AACN, Columbia, To complete this program, Card # Expiration Date Aliso Viejo, CA it took me hours/minutes. Signature The American Association of Critical-Care Nurses is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. AACN has been approved as a provider of continuing education in nursing by the State Boards of Nursing of Alabama (#ABNP62), California (#16), and Louisiana (#ABN12). AACN programming meets the standards for most other states requiring mandatory continuing education credit for relicensure.. a 8. a 9. a 1. a. a
Nurses knowledge about VAP
Nurses knowledge about VAP Journal of Nursing and Midwifery Sciences 2014: 1(1): 4448 http://jnms.mazums.ac.ir Original article Nurses knowledge of evidence based guidelines for preventing ventilatorassociated
More informationNurses Knowledge and Practice to Evidence-based. Guidelines for the Prevention of Ventilator Associated
Bulletin of High Institute of Public Health Vol. 40 No. 1 [2010] Nurses Knowledge and Practice to Evidence-based Guidelines for the Prevention of Ventilator Associated Pneumonia in Pediatric Intensive
More informationVENTILATOR ASSOCIATED PNEUMONIA (VAP) SOP VAP SK-V1
VENTILATOR ASSOCIATED PNEUMONIA (VAP) SOP Version Number V1 Date of Issue February 2018 Reference Number Review Interval Approved By Name: Fionnuala O Neill Title: Nurse Practice Coordinator Authorised
More informationMarianne Chulay is a critical care nursing/clinical research consultant in Chapel Hill, NC. The author has no financial relationships to disclose.
VAP is a common and potentially fatal complication of ventilator care. Following the latest CDC recommendations is the best defense you can offer your patients. Marianne Chulay, RN, DNSC, FAAN Marianne
More informationTitle: Length of use guidelines for oxygen tubing and face mask equipment
Title: Length of use guidelines for oxygen tubing and face mask equipment Date: September 12, 2007 Context and policy issues: There is concern that oxygen tubing and face mask equipment in the ventilator
More informationCritical Care Nurses' Knowledge and Compliance with Ventilator Associated Pneumonia Bundle at Cairo University Hospitals
Critical Care Nurses' Knowledge and Compliance with Ventilator Associated Pneumonia Bundle at Cairo University Hospitals Nahla Shaaban Ali (corresponding author) Lecturer of Critical Care and Emergency
More informationA STUDY TO ASSESS THE KNOWLEDGE OF CARDIAC NURSES ABOUT VENTILATOR CARE BUNDLE IN CONGENITAL CARDIAC ICU IN SCTIMST
A STUDY TO ASSESS THE KNOWLEDGE OF CARDIAC NURSES ABOUT VENTILATOR CARE BUNDLE IN CONGENITAL CARDIAC ICU IN SCTIMST PROJECT REPORT Submitted in the partial fulfillment of the requirements For the DIPLOMA
More informationNHS Innovation Accelerator. Economic Impact Evaluation Case Study: PneuX TM 1. BACKGROUND
NHS Innovation Accelerator Economic Impact Evaluation Case Study: PneuX TM 1. BACKGROUND The PneuX Pneumonia Prevention System is an endotracheal/tracheostomy tube system for airway management, designed
More informationCase: Comparing Two Scenarios
The Case: Case: Comparing Two Scenarios Dale Urdick and Lauren Weizhart are both Quality Improvement Managers at two large pediatric hospitals in different provinces. Although hundreds of kilomiles separate
More informationORAL CARE PRACTICES CRITICALLY ILL ADULTS FOR ORALLY INTUBATED. Pulmonary Critical Care
Pulmonary Critical Care ORAL CARE PRACTICES FOR ORALLY INTUBATED CRITICALLY ILL ADULTS By Laura L. Feider, RN, PhD, Pamela Mitchell, RN, PhD, and Elizabeth Bridges, RN, PhD, CCNS American Association of
More informationFinal scope for the systematic review of the clinical and cost effectiveness evidence for the prevention of ventilator-associated pneumonia (VAP)
Final scope for the systematic review of the clinical and cost effectiveness evidence for the prevention of ventilator-associated pneumonia (VAP) Contents 1. AIM...2 2. BACKGROUND...2 3. INTERVENTIONS...3
More informationSuctioning in Adult. Pulmonary Critical Care. 1.0 Hour
Pulmonary Critical Care Clinical Indicators for Endotracheal Suctioning in Adult Patients Receiving Mechanical Ventilation By Mary Lou Sole, RN, PhD, CCNS, Melody Bennett, RN, MN, CCRN, and Suzanne Ashworth,
More informationPolicies and Procedures. I.D. Number: 1145
Policies and Procedures Title: VENTILATION CHRONIC- CARE OF MECHANICALLY VENTILATED ADULT PERSON RNSP: RN Clinical Protocol: Advanced RN Intervention LPN Additional Competency: Care of Chronically Mechanically
More informationOROPHARYNGEAL. Pulmonary Critical Care. e141 AJCC AMERICAN JOURNAL OF CRITICAL CARE, November 2011, Volume 20, No. 6
Pulmonary Critical Care OROPHARYNGEAL SECRETION VOLUME IN INTUBATED PATIENTS: THE IMPORTANCE OF ORAL SUCTIONING By Mary Lou Sole, RN, PhD, CCNS, Daleen Aragon Penoyer, RN, PhD, CCRP, Melody Bennett, RN,
More informationActionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP)
Executive Summary Checklist Actionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP) In order to establish a program to reduce ventilator-associated pneumonia (VAP) the following
More informationCOMPARISON OF AIRWAY MANAGEMENT PRACTICES BETWEEN REGISTERED NURSES AND RESPIRATORY CARE PRACTITIONERS. Pulmonary Critical Care. 1.
Pulmonary Critical Care COMPARISON OF AIRWAY MANAGEMENT PRACTICES BETWEEN REGISTERED NURSES AND RESPIRATORY CARE PRACTITIONERS By Mary Lou Sole, RN, PhD, CCNS, and Melody Bennett, RN, MN, CCRN CNE 1. Hour
More informationPreventing ICU Complications. Lee-lynn Chen, MD Assistant Clinical Professor UCSF Department of Anesthesia and Perioperative Care
Preventing ICU Complications Lee-lynn Chen, MD Assistant Clinical Professor UCSF Department of Anesthesia and Perioperative Care Overview Catheter related bloodstream infection Ventilator associated pneumonia
More informationUsing People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers Melissa A. Fitzpatrick, RN, MSN, FAAN VP & Chief Clinical Officer, Hill-Rom Trends Driving Our Industry Aging
More informationHospital-acquired infections (HAIs) can lead to longer stays, higher health care costs, and
Feature Patients Hand Washing and Reducing Hospital- Acquired Infection Stacy Haverstick, RN, BSN, PCCN Cara Goodrich, MS, AGPCNP-BC Regi Freeman, RN, MSN, ACNS-BC Shandra James, RN, DNP Rajkiran Kullar,
More informationEND-TIDAL CARBON DIOXIDE AS A MEASURE
Critical Care Techniques END-TIDAL CARBON DIOXIDE AS A MEASURE OF STRESS RESPONSE TO CLUSTERED NURSING INTERVENTIONS IN NEUROLOGIC PATIENTS By Laura Genzler, RN, BSN, Pamela Jo Johnson, MPH, PhD, Neha
More informationThe impact of nighttime intensivists on medical intensive care unit infection-related indicators
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2016 The impact of nighttime intensivists on medical intensive care unit infection-related indicators Abhaya Trivedi
More informationPreventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 1-1-2014 Preventing
More informationSeattle Nursing Research Consortium Abstract Style and Reference Guide
Seattle Nursing Research Consortium Abstract Style and Reference Guide Page 1 SNRC Revised 7/2015 Table of Contents Content Page How to classify your Project. 3 Research Abstract Guidelines 4 Research
More informationSuccessful and Sustained VAP Prevention Patti DeJuilio, MS, RRT-NPS, Manager, Respiratory Care Services, Central DuPage Hospital, Winfield, IL
Successful and Sustained VAP Prevention Patti DeJuilio, MS, RRT-NPS, Manager, Respiratory Care Services, Central DuPage Hospital, Winfield, IL Objectives & About Us Central DuPage Hospital is a large community
More informationKey words: critical care; hospital costs; ICU; mechanical ventilation; outcome; ventilator-associated pneumonia
Epidemiology and Outcomes of Ventilator-Associated Pneumonia in a Large US Database* Jordi Rello, MD; Daniel A. Ollendorf, MPH; Gerry Oster, PhD; Montserrat Vera-Llonch, MD, MPH; Lisa Bellm, MIM; Rebecca
More informationROTOPRONE THERAPY SYSTEM. with people in mind.
ROTOPRONE THERAPY SYSTEM with people in mind www.arjohuntleigh.com THE CLINICAL CHALLENGE: MINIMIZING MORTALITY AND POTENTIAL COMPLICATIONS IN ARDS PATIENTS WHILE MAKING IT EASIER TO DELIVER PRONE THERAPY
More informationVentilator-associated pneumonia (VAP) is an EVIDENCE-BASED PRACTICE: USE OF THE VENTILATOR BUNDLE TO PREVENT VENTILATOR-ASSOCIATED PNEUMONIA
EVIDENCE-BASED PRACTICE: USE OF THE VENTILATOR BUNDLE TO PREVENT VENTILATOR-ASSOCIATED PNEUMONIA By Arlene F. Tolentino-DelosReyes, RN, MSN, ACNP, Susan D. Ruppert, RN, PhD, APRN, BC, NP-C, Shyang-Yun
More informationVAE PROJECT MASTER ACTION PLAN. Note: Please be aware that these areas overlap to reduce duplication and optimize the synergies
VAE PROJECT MASTER ACTION PLAN Note: Please be aware that these areas overlap to reduce duplication and optimize the synergies Practice NHSN Surveillance Data Collection Is VAE NHSN Surveillance data collection
More informationSemi-recumbent Position in ICU
Crit Care & Shock (2008) 11 : 61-66 Semi-recumbent Position in ICU Thomas ST Li, Gavin M. Joynt, Hing Y. So, Charles D. Gomersall, Florence HY Yap Abstract Purpose: Positioning mechanically ventilated
More information1. Introduction. Volume 6 Issue 4, April Hussein Hadi Atiyah, PhD 1, Musaab Majid Abdul-Wahhab, MSc.N 2, Sadeq A.
Nurses Knowledge toward Essential Care for Adult Patients Undergoing Mechanical Ventilation at Critical Care Unit in Baghdad City Hussein Hadi Atiyah, PhD 1, Musaab Majid Abdul-Wahhab, MSc.N 2, Sadeq A.Al-Fayyadh,
More informationThe Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications
The Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications Christine M. Schleider, RN, BSN Adam P. Johnson, MD, MPH Kathleen M. Shindle, RN, BSN Scott W. Cowan, MD,
More informationThere has been an explosive growth in
Acute Care Nurse Practitioner as Hospitalist: Role Description Laura D. Rosenthal, MSN, ACNP, CFRN Jeannette Guerrasio, MD CEContinuing Education There has been an explosive growth in the practice roles
More informationFHA Call to Action: Eliminating Infection-Related Ventilator-Associated Complications IVAC Bi-Monthly Webinar #2 May 3, 2018
FHA Call to Action: Eliminating Infection-Related Ventilator-Associated Complications IVAC Bi-Monthly Webinar #2 May 3, 2018 Agenda FHA MTC Call to Action for IVAC Data Review HRET HIIN Hospital Peer Sharing
More informationBEDSIDE NURSES PERCEPTIONS OF INTENSIVE CARE UNIT TELEMEDICINE. Innovative Approaches. 1.0 Hour
Innovative Approaches BEDSIDE NURSES PERCEPTIONS OF INTENSIVE CARE UNIT TELEMEDICINE By Margaret Mullen-Fortino, RN, MSN, Joseph DiMartino, RN, MSN, Lorraine Entrikin, RN, BSN, Sophia Mulliner, RN, BSN,
More informationGoal Elements of Performance APIC Comments APIC Recommendations
Association for Professionals in Infection Control and Epidemiology, Inc. Comments on the Joint Commission s Proposed 2012 National Patient Safety Goals The Joint Commission Practice Guidance Team Accreditation
More informationDOI: /chest This information is current as of July 22, 2005
An Educational Intervention to Reduce Ventilator-Associated Pneumonia in an Integrated Health System: A Comparison of Effects Hilary M. Babcock, Jeanne E. Zack, Teresa Garrison, Ellen Trovillion, Marilyn
More informationReducing Ventilator Associated Pneumonia (V.A.P) System and Patient Tracer
Reducing V.A.P.: SYSTEM Tracer Begin with Large Group General Questions: 1. Describe your surgical and then medical process related to the prevention of V.A.P. 2. The Team Leader will create questions
More informationHealthcare-Associated Infections
Healthcare-Associated Infections A healthcare crisis requiring European leadership Healthcare-associated infections (HAIs - also referred to as nosocomial infections) are defined as an infection occurring
More informationExemplary Professional Practice: Patient Care Delivery Model(s)
Exemplary Professional Practice: Patient Care Delivery Model(s) EP7EO Nurses systematically evaluate professional organizations standards of practice, incorporating them into the organization s professional
More informationKnowledge about systemic inflammatory response syndrome and sepsis: a survey among Dutch emergency department nurses
van den Hengel et al. International Journal of Emergency Medicine (2016) 9:19 DOI 10.1186/s12245-016-0119-2 International Journal of Emergency Medicine ORIGINAL RESEARCH Knowledge about systemic inflammatory
More informationFailure to Maintain: Missed Care and Hospital-Acquired Pneumonia
Failure to Maintain: Missed Care and Hospital-Acquired Pneumonia STTI INDIANAPOLIS, OCTOBER 2017 DIAN BAKER, PHD, RN PROFESSOR, SCHOOL OF NURSING DIBAKER@CSUS.EDU CALIFORNIA STATE UNIVERSITY, SACRAMENTO
More informationManagement for Preventing Ventilator-Associated Pneumonia at ICU Panti Rapih Hospital: A Clinical Case Study
Nurse Media Journal of Nursing, 6 (1), 2016, 30-36 Available Online at http://ejournal.undip.ac.id/index.php/medianers Management for Preventing Ventilator-Associated Pneumonia at ICU Panti Rapih Hospital:
More informationCurrent practice of closed-loop mechanical ventilation modes on intensive care units a nationwide survey in the Netherlands
ORIGINAL ARTICLE Current practice of closed-loop mechanical ventilation modes on intensive care units a nationwide survey in the Netherlands E.F.E. Wenstedt 1 *, A.J.R. De Bie Dekker 1, A.N. Roos 1, J.J.M.
More informationDawn Vollers, RN, APN, BC Edie Hill, RN, MPA, BSN, CNOR Cynthia Roberts, RN, MS Lori Dambaugh, RN, BSN, BC, PCCN Zara R. Brenner, RN-BC, MS, ACNS-BC
Cover Article AACN s Healthy Work Environ ment Standards and an Empowering Nurse Advancement System PRIME POINTS Nurse advancement systems provide a process for recognizing nurses who move from novice
More informationHAWAII HEALTH SYSTEMS CORPORATION
All Positions HE-13 6.822 Function and Location This position works in the respiratory therapy unit of a hospital and is responsible for supervising several respiratory therapy technicians in providing
More informationImplementation of a Ventilator Associated Pneumonia Prevention Bundle in a Single. Pediatric Intensive Care Unit
Implementation of a Ventilator Associated Pneumonia Prevention Bundle in a Single Pediatric Intensive Care Unit Analía De Cristofano MD 1, Verónica Peuchot MD 2, Andrea Canepari RT 3, Victoria Franco RN
More informationVAP 1. Virtual Project: Ventilator Associated Pneumonia. [Erich Vetter] Virtual Project: Ventilator Associated Pneumonia.
VAP 1 Virtual Project: Ventilator Associated Pneumonia [Erich Vetter] Virtual Project: Ventilator Associated Pneumonia Introduction In different wards and units of the hospital, nurses are important to
More informationBarriers to Early Rehabilitation in Critically Ill Patients. Shannon Goddard, MD Sunnybrook Health Sciences Centre
Barriers to Early Rehabilitation in Critically Ill Patients Shannon Goddard, MD Sunnybrook Health Sciences Centre Disclosures/Funding No financial disclosures or conflicts of interest Work is funding by
More informationBest Practices for Prevention of Ventilator Associated Pneumonia. Marti Shaver, RN, CIC Derreck Wallace, RRT Ruth Sidor, MSN APRN
Best Practices for Prevention of Ventilator Associated Pneumonia Marti Shaver, RN, CIC Derreck Wallace, RRT Ruth Sidor, MSN APRN North Decatur Hillandale Downtown Decatur DeKalb Regional Health System
More informationThree versus seven day circuit changes of humidified oxygen circuitry: a feasibility study
Three versus seven day circuit changes of humidified oxygen circuitry: a feasibility study AUTHORS Joan Webster RN, RM, BA Associate Professor, Nursing Director Research, Centre for Clinical Nursing, Royal
More informationVentilator-Associated Pneumonia Prevention Bundle
Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 Ventilator-Associated Pneumonia Prevention Bundle Patricia Cal Walden
More informationBarriers to Early Rehabilitation in Critically Ill Patients. Shannon Goddard, MD Sunnybrook Health Sciences Centre
Barriers to Early Rehabilitation in Critically Ill Patients Shannon Goddard, MD Sunnybrook Health Sciences Centre Disclosures/Funding No financial disclosures or conflicts of interest Work is funding by
More informationNURSES PERCEPTIONS DURING RESUSCITATION OF FAMILY PRESENCE. Families in Critical Care
Families in Critical Care NURSES PERCEPTIONS OF FAMILY PRESENCE DURING RESUSCITATION By Kelly Tudor, RN, BSN, CCRN, Jill Berger, RN, MSN, MBA, NE-BC, Barbara J. Polivka, RN, PhD, Rachael Chlebowy, RN,
More informationA New, National Approach to Surveillance for Ventilator-associated Events; Challenges and Opportunities
A New, National Approach to Surveillance for Ventilator-associated Events; Challenges and Opportunities Linda R.Greene,RN,MPS,CIC Manager of Infection Prevention Highland Hospital Rochester, NY Affiliate
More informationImplementing Rapid Response Teams Audio Conferences
Upcoming Distance Learning Opportunity from the Idaho Hospital Association Implementing Rapid Response Teams Audio Conferences Thursday, April 19, 2007 Saving Lives with Rapid Response Teams Thursday,
More informationPrevention and management of ventilator-associated pneumonia the Care Bundle approach
ARTICLE Prevention and management of ventilator-associated pneumonia the Care Bundle approach Department of Anaesthesia and Critical Care, Groote Schuur Hospital and University of Cape Town R Gillespie,
More informationCan We Identify Patients at High Risk for Unplanned Extubation? A Large-Scale Multidisciplinary Survey
Can We Identify Patients at High Risk for Unplanned Extubation? A Large-Scale Multidisciplinary Survey Maged A Tanios MD MPH, Scott K Epstein MD, Jeanette Livelo RN MBA, and Daniel Teres MD BACKGROUND:
More informationVentilator Bundle Compliance: Report from a Neurosurgical Intensive Care Unit
Original Article Crit Care & Shock (2009) 12:109-116 Ventilator Bundle Compliance: Report from a Neurosurgical Intensive Care Unit Lincoln Jiménez, Emil A. Pastrana, Gloria Rodríguez-Vega, John D. Rolston
More informationNUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #49
Carol Rees Parrish, R.D., M.S., Series Editor Prevention of Aspiration Pneumonia in the Enterally Fed Critically Ill Ventilated Patients: Keeping the Head Up Takes a Village! Suzanne M. Burns One of the
More information19th Annual. Challenges. in Critical Care
19th Annual Challenges in Critical Care A Multidisciplinary Approach Friday August 22, 2014 The Hotel Hershey 100 Hotel Road Hershey, Pennsylvania 17033 A continuing education service of Penn State College
More informationdoes staff intervene; used? If not, describe.
Use this pathway for a resident who requires or receives respiratory care services (i.e., oxygen therapy, breathing exercises, sleep apnea, nebulizers/metered-dose inhalers, tracheostomy, or ventilator)
More informationCan nurses Compliance to Ventilator Care Bundle Help to Prevent Ventilator Associated Pneumonia in ICU? Mok Chi Man, RN (SP) ICU, PYNEH, HKEC
Can nurses Compliance to Ventilator Care Bundle Help to Prevent Ventilator Associated Pneumonia in ICU? Mok Chi Man, RN (SP) ICU, PYNEH, HKEC 1 Introduction Ventilator-associated pneumonia (VAP): Lung
More informationTHE CRITICAL CARE WORK ENVIRONMENT HEALTH CARE ASSOCIATED INFECTIONS AND NURSE-REPORTED. Patient Safety Issues. 1.0 Hour
Patient Safety Issues THE CRITICAL CARE WORK ENVIRONMENT AND NURSE-REPORTED HEALTH CARE ASSOCIATED INFECTIONS By Deena Kelly, RN, PhD, Ann Kutney-Lee, RN, PhD, Eileen T. Lake, RN, PhD, and Linda H. Aiken,
More informationVAP Prevention in the CTICU
The University of San Francisco USF Scholarship: a digital repository @ Gleeson Library Geschke Center Master's Projects and Capstones Theses, Dissertations, Capstones and Projects Spring 5-22-2015 VAP
More informationA Resident-led PICU Morbidity and Mortality Conference
A Resident-led PICU Morbidity and Mortality Conference James Moses, MD, MPH Associate Program Director Boston Combined Residency Program Director of Patient Safety and Quality Department of Pediatrics
More informationHealthcare-Associated Infections in U.S. Nursing Homes: Results from a Prevalence Survey Pilot
Healthcare-Associated Infections in U.S. Nursing Homes: Results from a Prevalence Survey Pilot Lisa La Place, MPH, Lauren Epstein, MD, Deborah Thompson, MD, Ghinwa Dumyati, MD, Cathleen Concannon, MPH,
More informationUnit length of stay and APACHE II scores for ventilated admissions to critical care in England, Wales and Northern Ireland
Unit length of stay and APACHE II scores for ventilated admissions to critical care in England, Wales and Northern Ireland Questions What was the unit length of stay and APACHE II scores for ventilated
More informationActionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP)
Executive Summary Checklist Actionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP) Pneumonia that is acquired while a patient is receiving mechanically-assisted ventilation
More informationETHNOGRAPHIC INVESTIGATION OF ORAL CARE IN THE INTENSIVE CARE UNIT. Pulmonary Critical Care. 1.0 Hour
Pulmonary Critical Care ETHNOGRAPHIC INVESTIGATION OF ORAL CARE IN THE INTENSIVE CARE UNIT By Craig M. Dale, RN, PhD, Jan E. Angus, RN, PhD, Tasnim Sinuff, MD, PhD, and Louise Rose, RN, PhD C E 1.0 Hour
More informationEffect of DNP & MSN Evidence-Based Practice (EBP) Courses on Nursing Students Use of EBP
Effect of DNP & MSN Evidence-Based Practice (EBP) Courses on Nursing Students Use of EBP Richard Watters, PhD, RN Elizabeth R Moore PhD, RN Kenneth A. Wallston PhD Page 1 Disclosures Conflict of interest
More informationNursing orientation for acute or critical care
Clinical Evidence Review A regular feature of the American Journal of Critical Care, Clinical Evidence Review unveils available scientific evidence to answer questions faced in contemporary clinical practice.
More informationCLINICAL PREDICTORS OF DURATION OF MECHANICAL VENTILATION IN THE ICU. Jessica Spence, BMR(OT), BSc(Med), MD PGY2 Anesthesia
CLINICAL PREDICTORS OF DURATION OF MECHANICAL VENTILATION IN THE ICU Jessica Spence, BMR(OT), BSc(Med), MD PGY2 Anesthesia OBJECTIVES To discuss some of the factors that may predict duration of invasive
More informationDetermining Like Hospitals for Benchmarking Paper #2778
Determining Like Hospitals for Benchmarking Paper #2778 Diane Storer Brown, RN, PhD, FNAHQ, FAAN Kaiser Permanente Northern California, Oakland, CA, Nancy E. Donaldson, RN, DNSc, FAAN Department of Physiological
More informationSARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: TRACHEOSTOMY SPEAKING VALVE EFFECTIVE DATE: REVISED DATE: POLICY TYPE: 135.008 (Respiratory Therapy) (Patient Care) 134.900 (Rehab) 10/93
More informationPurpose of the Survey. Research Team Pat Bruckenthal, PhD, RN, ANP: PI
Gender, experience, type of hospital, and culture are associated with Pain Knowledge and Attitudes among registered nurses: A regional survey. Pat Bruckenthal, PhD, RN, ANP Clinical Associate Professor
More informationThe ventilator care bundle and its impact on ventilator-associated pneumonia: a review of the evidence
LITERATURE REVIEW doi: 10.1111/j.1478-5153.2010.00430.x The ventilator care bundle and its impact on ventilator-associated pneumonia: a review of the evidence Petra Lawrence and Paul Fulbrook ABSTRACT
More informationAn economic - quality business case for infection control & Prof. dr. Dominique Vandijck
An economic - quality business case for infection control & prevention @VandijckD Prof. dr. Dominique Vandijck What you/we all know, (hopefully) but do our healthcare executives, and politicians know this?
More informationPolicies and Procedures. ID Number: 1138
Policies and Procedures Title: VENTILATION Acute-Care of Mechanically Ventilated Patient - Adult RN Specialty Practice: RN Clinical Protocol: Advanced RN Intervention ID Number: 1138 Authorization: [X]
More informationSCHOOL - A CASE ANALYSIS OF ICT ENABLED EDUCATION PROJECT IN KERALA
CHAPTER V IT@ SCHOOL - A CASE ANALYSIS OF ICT ENABLED EDUCATION PROJECT IN KERALA 5.1 Analysis of primary data collected from Students 5.1.1 Objectives 5.1.2 Hypotheses 5.1.2 Findings of the Study among
More informationHCA Infection Control Surveillance Survey
HCA Infection Control Surveillance Survey HCA is very interested in reducing nosocomial infections in its hospitals. A key to reducing infections is for each hospital to have a robust infection control
More informationType of intervention Treatment. Economic study type Cost-effectiveness analysis.
Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure Nava S, Evangelisti I, Rampulla C, Compagnoni M L, Fracchia C, Rubini F Record
More informationConflict of Interest Disclaimer. The Affordable Care Act. The Affordable Care Act. Caring for the Critically Ill. The Affordable Care Act
Conflict of Interest Disclaimer Reducing Risks of Harmful Events in the Critically Ill I have no financial interests or conflicts of interest related to this talk Alfred F. Connors, Jr., MD Chief Medical
More informationImpacting quality outcomes: Utilizing an innovative unit-based nursing role. Kaitlin Lindner, BSN, RN, CCRN Stacey Trotman, MSN, RN, CMSRN, RN-BC
Impacting quality outcomes: Utilizing an innovative unit-based nursing role Kaitlin Lindner, BSN, RN, CCRN Stacey Trotman, MSN, RN, CMSRN, RN-BC Outcomes Identify opportunities for improving quality outcomes
More informationJournal of American Science 2016;12(2)
Efficacy of Implementing Nursing Care Protocol on the Incidence of Ventilator Associated Pneumonia in Intensive Care Unit at Tanta Emergency Hospital Zeinab Mohammed Shaban Aysha 1, Sanaa Mohamed Alaa
More informationFeedback from Anesthesia clinicians. 2.1 Intubate Patient Workflow
Feedback from Anesthesia clinicians 2.1 Intubate Patient Workflow The following section describes the workflow as derived from the Intubate Patient use case analysis. Intubate Patient (Process) This process
More informationQuality Indicators in Neonatal Medicine
Quality Indicators in Neonatal Medicine Potential collaborative research projects Imad MELKI M.D. NCPNN Quality Indicators: 1- An agreed-upon process or outcome measure that is used to determine the level
More informationASA Survey Results for Commercial Fees Paid for Anesthesia Services practice management
practice management ASA Survey Results for Commercial Fees Paid for Anesthesia Services 2013 Stanley W. Stead, M.D., M.B.A Sharon K. Merrick, M.S., CCS-P Thomas R. Miller, Ph.D., M.B.A. ASA is pleased
More informationInternational Journal of Scientific and Research Publications, Volume 7, Issue 8, August ISSN
International Journal of Scientific and Research Publications, Volume 7, Issue 8, August 2017 469 (Effectiveness of an Educational Program upon nurses knowledge toward The Continuous Positive Airway Pressure
More informationSupplementary Online Content
Supplementary Online Content Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012.
More informationThe impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia
Intensive and Critical Care Nursing (2007) 23, 132 136 ORIGINAL ARTICLE The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia
More informationRita Hunsucker, DNP, Nicole Cornell, MS, Gerald Hobbs, PhD, Jorge Con, MD & Alison Wilson, MD WVU Medicine, J.W. Ruby Memorial Hospital
Rita Hunsucker, DNP, Nicole Cornell, MS, Gerald Hobbs, PhD, Jorge Con, MD & Alison Wilson, MD WVU Medicine, J.W. Ruby Memorial Hospital The authors have nothing to disclose. Post extubation dysphagia (PED)
More informationICU Nurses Perceptions of Nutrition Education and Training. October 17, 2011 Gwynne MacDonald, Cathy Alberda and Leah Gramlich
ICU Nurses Perceptions of Nutrition Education and Training October 17, 2011 Gwynne MacDonald, Cathy Alberda and Leah Gramlich Why bother feeding? Increased energy and protein associated with lower mortality
More informationHelen Kenedi, M.S., CCC-SLP Jenny Reynolds, M.S., CCC-SLP JoBeth Vance, M.S., CCC-SLP
Helen Kenedi, M.S., CCC-SLP Jenny Reynolds, M.S., CCC-SLP JoBeth Vance, M.S., CCC-SLP Disclosure Helen Kenedi, Jenny Reynolds, and JoBeth Vance have no financial or nonfinancial disclosures and do not
More informationTracheostomy Care Test Questions
Care Test Questions Free PDF ebook Download: Care Test Questions Download or Read Online ebook tracheostomy care test questions in PDF Format From The Best User Guide Database Ask questions about caring
More informationHOSPITAL ACQUIRED COMPLICATIONS. Shruti Scott, DO, MPH Department of Medicine UCI Hospitalist Program
HOSPITAL ACQUIRED COMPLICATIONS Shruti Scott, DO, MPH Department of Medicine UCI Hospitalist Program HOSPITAL ACQUIRED COMPLICATIONS (HACS) A medical condition or complication that a patient develops during
More informationAdmissions with neutropenic sepsis in adult, general critical care units in England, Wales and Northern Ireland
Admissions with neutropenic sepsis in adult, general critical care units in England, Wales and Northern Ireland Question What were the: age; gender; APACHE II score; ICNARC physiology score; critical care
More informationDaily Interruptions of Sedation: A Clinical Approach to Improve Outcomes in Critically Ill Patients
Feature Daily Interruptions of Sedation: A Clinical Approach to Improve Outcomes in Critically Ill Patients Elizabeth Berry, MSN, ACNP-BC Heather Zecca, MSN, ACNP-BC The continuous infusion of sedative
More informationBIOSTATISTICS CASE STUDY 2: Tests of Association for Categorical Data STUDENT VERSION
STUDENT VERSION July 28, 2009 BIOSTAT Case Study 2: Time to Complete Exercise: 45 minutes LEARNING OBJECTIVES At the completion of this Case Study, participants should be able to: Compare two or more proportions
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Effectiveness of Self Instructional Module (SIM) on Current Trends of Vaccination in Terms
More informationJuly 10, reduce the risk of staff or patient airborne exposure to communicable diseases during surgical procedures (See Appendix A) and
TITLE GUIDELINE APPROVING AUTHORITY Infection Prevention and Control Operations PRACTICE SUPPORT DOCUMENT SPONSOR Infection Prevention and Control If you have any questions or comments regarding the information
More information