My PICO project will be about hospital acquired phenomena.P: Surgical patients or patient that are in the hospital for long periods of time may acquire hospital phenomena.
I: Turning patients every two hours, early ambulation and use of an incentive spirometer.
C: Antibiotic treatment, ambulation, cough and deep breathing.
P: Surgical patients or patient that are in the hospital for long periods of time may acquire hospital phenomena.
I: Turning patients every two hours, early ambulation and use of an incentive spirometer.
C: Antibiotic treatment, ambulation, cough and deep breathing.
O: Shorter hospital stays, less coast for patient, improving health.
T: This plan will start immediately, and check results in 3 weeks.
Can hospital acquired phenomena be avoided by educating staff. If patients are turned every two hours, ambulated when possible. Surgical patients are instructed to cough and deep breath and using an incentive spirometer. This could decrease hospital stay and increase health for the patient and lower coast.
Reference articles you can use:
Hospital acquired-pneumonia (HPA)
1. Chung, D. R., Song, J., Kim, S. H., Thamlikitkul, V., Huang, S., Wang, H., . . . Peck, K. R. (2011). High Prevalence of Multidrug-Resistant Non-fermenters in Hospital-acquired Pneumonia in Asia. Am J Respir Crit Care Med American Journal of Respiratory and Critical Care Medicine, 184(12), 1409-1417.
According to Chung et Al. HAP and VAP are the most significant causes of death and have an increased antibacterial resistance. The statistical findings show that major bacteria responsible for HAP and VAP were Acinetobacter ssp, Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella pneumonia. 67.3% of Acinetobacter ssp and 27.2% of Pseudomonas aeruginosa are resistant to imipenem treatment. The mortality rate is 38.9%. The study suggests the use of discordant initial empirical antimicrobial therapy to decrease the mortality rate of pneumonia-related infections.
2. Freire, A. T., Melnyk, V., Kim, M. J., Datsenko, O., Dzyublik, O., Glumcher, F., . . . Gandjini, H. (2010). Comparison of tigecycline with imipenem/cilastatin for the treatment of hospital-acquired pneumonia. Diagnostic Microbiology and Infectious Disease, 68(2), 140-151.
Tigecycline and imipenem are used for the treatment of HAP treatment. The study involved 945 patients where 67.9% responded to the cure of tigecycline and 78.2% of imipenem in clinically evaluable patients. 62.7% responded to the cure of tigecycline and 67.6% to that of imipenem in clinical modified intent-to-treat patients. The mortality rate of tegicycline is 14.1% while that of imipenem is 12.6%.Imipenem is more effective than tigecycline and thus, should be used more to cure people with HAP.
3. Hudcova, J., & Craven, D. E. (2013). Ventilator-associated pneumonia. Hospital-Acquired Pneumonia, 48-65.
HAP has various factors that enable its spread. Some of the risk factors such as malnutrition, general cleanliness are modifiable while others such as an acute, chronic disease are not preventable. Patients with critical risks of being infected with HAP such as those in mechanical ventilation, for instance, 9-40% patients on mechanical ventilation are at risk to be infected by HAP. The incidence of HAP among patients in the United States is 0.5-2% and has a mortality rate of 30-70%.The hospitals and other healthcare institutions should ensure they incorporate the general preventive measures such as washing hands to enable them to reduce the disease incidents.
4. Masterton, R. G., Galloway, A., French, G., Street, M., Armstrong, J., Brown, E., . . . Wilcox, M. (2008). Guidelines for the management of hospital-acquired pneumonia in the UK: Report of the Working Party on Hospital-Acquired Pneumonia of the British Society for Antimicrobial Chemotherapy. Journal of Antimicrobial Chemotherapy, 62(1), 5-34.
According to Master HAP is a respiratory infection that develops after more than 48 hours of being admitted to the hospital. Ventilator-associated pneumonia is the most common HAP. HAP can be an early set caused by antibiotic-susceptible community type pathogen or late infection brought by antibiotic –resistant bacteria. HAP is a nosocomial disease and affects the illest patients and also those who have overstayed in the hospital. The article is not comprehensive since it does not give it does not give full evidence on the guidelines to be used. The study found that the percentage of intercellular organisms found that removal of less 2% infected cells gave a response of 80% to 82%. It is beneficial using the selective decontamination of the digestive tract method since it reduces mortality and morbidity rates of VAP. The gravity of HAP is not affected the number of ventilator machines are changed other it increases the cost.HAP affects 0.5% to 1% patients in the hospital thus being the most common healthcare-associated infections(HCAI). HAP associated with VAP has a mortality rate of 24% to 50% that is increased to 76% when caused by resistance to drug-resistant pathogens. VAP causes a morbidity rate of 25% for patients in the ICUs infections depending on the number of days spent in the mechanical ventilation. The study recommended the introduction of protocols for HAP empirical therapy in the affected clinical setting. The therapy improves outcomes economically and microbiologically without efficiency compromise. They also recommended a change of ventilator circuits before seven days to help control costs of maintenance.
