Pneumonia is a lung infection caused by bacteria, virus, or fungus. The most direct endogenous sources of any of these microorganisms include infected nasal carriers, sinusitis, oropharynx, gastric, or tracheal colonization, and hematogenous spread (Alcon Fabregas & Torres, 2005). Although much is known about pneumonia, it remains the leading infectious cause of hospitalization and death in the United States ("Pneumonia," n.d.). One of the reasons why pneumonia is common is that the lungs are exposed to some ten thousand liters of air each day, as well as small amounts of saliva and even occasionally aspirated regurgitation, all of which can contain bacteria, viral and fungal agents, and other pathogens ("Pneumonia," n.d.).
Although pneumonia is contagious via airborne particles shared by infected persons, self-infection is far more common. This is why oral hygiene, nutrition, and other lifestyle issues are central to reducing disease prevalence. When the immune system has been compromised already,…...
mlaReferences
Alcon A1, Fabregas N, Torres A. (2005). Pathophysiology of pneumonia. Clin Chest Med. 2005 Mar; 26(1):39-46.
Mayo Clinic Staff (2014). Pneumonia. Retrieved online: http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/causes/con-20020032
"Pneumonia." Chapter 15. Retrieved online: http://www.thoracic.org/education/breathing-in-america/resources/chapter-15-pneumonia.pdf
"Pneumonia - Pathophysiology Of Pneumonia," (n.d.). Retrieved online: http://science.jrank.org/pages/5358/Pneumonia-Pathophysiology-pneumonia.html
Pneumonia and Timely Antibiotic Therapy
The purpose of this project to educate hospital staff concerning the fact that research supports a best practice protocol that pneumonia patients should be provided with antibiotics within 4 hours of being admitted to the hospital. Pneumonia is defined by Evans and Tippins (2007) as being "an acute inflammation of the lower respiratory tract most commonly due to viral and bacterial infection. Areas or lobes of the lungs become consolidated resulting in an impairment of gas exchange" (p. 224). The environment of the project is a tertiary hospital facility that provides surgical, medical and rehabilitation services. The question is whether pneumonia patients should be given antibiotics within a certain time frame, such as 4 hours after being admitted to the hospital. At present, pneumonia remains the leading cause of death attributable to infection in patients aged 65 years and older and accounts for 13% to 48%…...
mlaReferences
Evans, C. & Tippins, E. (2007). The foundations of emergency care. Maidenhead, England:
Four hours to start treatment of pneumonia? (2006). Clinical Infectious Diseases, 43(11), v-vi.
Houck PM, Bratzler DW, & Nsa W, Ma A, etc. (March 22, 2007). Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-
acquired pneumonia. Retrieved from www.ncbi.nlm.nih.gov/pubmed/15037492.
Pneumonia Case Study
The general statistics and facts about the patient are as follows. The patient is a Caucasian whit e email that is 52 years old. She was admitted to St. Mary's hospital on 12/12/2012. She stood a bit over five feet tall and weighed around 128 pounds. She was married with two grown children and lives in a small camping trailer as opposed to a conventional home or apartment/room.
Both the patient herself and the spouse of the patient are of disabled status. Advanced directives for the patient were in force as of the date of admission of the patient, again that being 12/12/2012. The purpose of the admission on 12/12/2012 was for a pneumonectomy. The patient was prior-diagnosed with necrotizing pneumonia in August 2012 and she hoad a lobectomy in Sepbemter. However, the necrotizing pneumonia destroyed the rest of the patient's lung.
The patient in question had had a number…...
The best nursing practice in the specific case would be not only the direct care of the young patient, but also the inclusion of the family in the in house hospital care as to provide an example of what is to be done at home in order to prevent relapse. Many family members might mistakenly believe that their own form of care will be sufficient in the case of a child's illness. However, it is the nurse's duty in such cases to prove to those family members that they need to follow specific and professionally proven methodologies in order to succeed in the recovery process, "Proponents of professionally-centered models view professionals as experts who determine child and family needs from their own as opposed to a family's perspective," (Trivette, Carl J.; Dunst, Carl; Boyd, Kimberly; Hamby, Debra W., 1995). By involving the family in the necessary care practices in house,…...
mlaReferences
Trivette, Carol M.; Dunst, Carl J.; Boyd, Kimberly; Hamby, Deborah W. (1995). Family-orientated program models, helpgiving practices and parental control appraisals. Exceptional Children. Vol. 62.
These factors were examined in the work of Tolentino-DelosReyes, et al. (2007) who report themselves having conducted a study and in the form of the administration of a test containing ten items which was developed for the purpose of scoring the nurse on knowledge related to VAP. These questions were comprised by a Powerpoint presentation utilized by the project director in the education sessions in the CCU and SICU. The test specifically were related to "best-practice guidelines, microorganisms that cause VAP, hand washing, supine positioning, enteral feeding, factors related to VAP, definition of VAP, and diagnosis of pneumonia." (Tolentino-DelosReyes, et al., 2007) Stated as participants in the reported study were 14 nurses on day shift and another 14 night shift nurses along with 15 day shift and 18 night shift nurses from the CCU comprising a stated "65% to 70% of all the nurses in each unit." (Tolentino-DelosReyes, et…...
Topic: Pneumonia readmissions among nursing home residents 65 years and older in the United States of America.
Backdrop of the dilemma
Pneumonia remains an extreme health condition in America. It accounts for roughly 1 million medical-center admissions and over 50,000 fatalities yearly. Roughly ten to twenty percent of pneumonia occurrences need admittance to the Intensive Care Unit or ICU. Moreover, pneumonia accounts for near to 140,000 medical-center readmissions each year, pricing in excess of 10 billion dollars in medical expenses. Unsurprisingly, in the age of reputation and expense awareness, pneumonia re-admission levels for older people over Sixty-five years have grown to be a topic of greater attention and quality enhancement endeavors. Together with the Affordable Care Federal act enactment, the Centers for Medicare And Medicaid Solutions (CMS) keeps medical-centers responsible for extra re-hospitalizations by connecting readmission levels to compensation. In 2013, CMS recognized 2,225 medical-centers for compensation decrease in keeping with readmission…...
mlaReferences
Calvillo, L., Arnold, D., Eubank, K. J., Lo, M., Yunyongying, P., Stieglitz, H., & Halm, E. A. (2013). Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. Journal of general internal medicine, 28(2), 269-282.De Alba, I., & Amin, A. (2014). Pneumonia readmissions: risk factors and implications. The Ochsner Journal, 14(4), 649-654.Donzé, J., Lipsitz, S., Bates, D. W., & Schnipper, J. L. (2013). Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study. Bmj, 347, f7171.Hansen, L. O., Greenwald, J. L., Budnitz, T., Howell, E., Halasyamani, L., Maynard, G., ... & Williams, M. V. (2013). Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization. Journal of hospital medicine, 8(8), 421-427.McHugh, M. D., & Ma, C. (2013). Hospital Nursing and 30-Day Readmissions among Medicare Patients with Heart Failure, Acute Myocardial Infarction, and Pneumonia. Medical Care, 51(1), 52–59. Shorr, A. F., Zilberberg, M. D., Reichley, R., Kan, J., Hoban, A., Hoffman, J., ... & Kollef, M. H. (2013). Readmission following hospitalization for pneumonia: the impact of pneumonia type and its implication for hospitals. Clinical infectious diseases, 57(3), 362-367.Weinreich, M., Nguyen, O. K., Wang, D., Mayo, H., Mortensen, E. M., Halm, E. A., & Makam, A. N. (2016). Predicting the risk of readmission in pneumonia. a systematic review of model performance. Annals of the American Thoracic Society, 13(9), 1607-1614.Yelena, M. S., Pratt, L. A., Kramarow, E. A., & Elgaddal, N. (2015). Hospitalization, Readmission, and Death Experience of Noninstitutionalized Medicare Fee-for-service Beneficiaries Aged 65 and Over.http://doi.org/10.1097/MLR.0b013e3182763284
Ventilator Associated Pneumonia reflects the most common healthcare related infection in the process of providing intensive care within the context of the hospital. The condition enhances the morbidity, mortality, length of stay, and costs increments. Ventilator Associated Pneumonia possesses significant threat to the development of human beings because of the costs and complexion of the condition. The condition occurs under the watch of the nurses who have the responsibility of providing extensive care to patients. Since the condition is complex, it is essential to focus on its prevention rather than treatment thus reduction in the total costs and adverse effects in association with Ventilator Associate Pneumonia (Zilberberg et al., 2011). This calls for the development of the implementation plan (K-1) to enable the prevention and reduction of the Ventilator Associated Pneumonia.
The population in which the solution is intended, the staff that will participate, and the key contributors that must…...
mlaReferences
Zilberberg, M., & Shorr, A. (2011). Ventilator-associated pneumonia as a model for approaching cost-effectiveness and infection prevention in the ICU. Current Opinion In Infectious
Diseases, 24(4), 385-389. doi:10.1097/QCO.0b013e3283474914
Uneja et al. (2011). Prevention and management of ventilator-associated pneumonia: A survey on current practices by intensivists practicing in the Indian subcontinent. Indian Journal
Of Anaesthesia, 55(2), 122-128. doi:10.4103/0019-5049.79889
VAP
Ventilator Associated Pneumonia: eview and Critique of a Quantitative esearch Article
Ventilator associated pneumonia is a significant problem affecting many patients that are intubated during hospital stays (NIH, 2012). Understanding and addressing this problem requires careful attention to the latest research, and this research must be approached from a critical perspective. Quantitative research, or research that directly and concretely measures certain phenomenon and describes relationships in numerical terms, has yielded no small amount of useful information on this topic, and critically examining a current article that outlines the knowledge regarding ventilator associated pneumonia is an excellent way to determine if there are any knowledge gaps or inconsistencies that require attention (Burns & Grove, 2011). The following paragraphs present just such an examination.
Problem Statement
A substantial portion of patients intubated for ventilator-assisted breathing during hospital stays develop pneumonia as a result of infection spread or allowed to flourish at the intubation site (Chastre…...
mlaReferences
Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th ed.). New York: Elsevier.
Chastre, J. & Fogan, J. (2002). Ventilator-associated pneumonia. American Journal of Respiratory Critical Care Medicine 165(7): 867-903.
NIH. (2012). Hospital-acquired pneumonia. Accessed 18 July 2012. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001201/
A study conducted by Ledgerwood et al. (2013) on the effects of tracheotomy tubes that have suction above the cuff established that the tubes have the capability to reduce VAP incidents. The amount of time spent in ICU and on the ventilator was also reduced. This does demonstrate that the patient was accorded the best treatment available to drain pleural effusion. The development of haemothorax/pneumothorax is anticipated in most patients who are intubated, but the risk is normally reduced. According to the different studies conducted, the likelihood of a patient suffering from VAP is decreased slightly when using SSD. The patient would still have contracted VAP if they were not intubated with the endotracheal tube. Therefore, the patient ended up incurring higher medical costs as they had to pay for the tube, and haemothorax/pneumothorax treatment. If they had not been intubated the patient would have only paid for the sickness.…...
mlaReferences
BOUZA, E., PEREZ, A., MUNOZ, P., PEREZ, M.J., RINC "N, C., SANCHEZ, C., MARTON-RABADAN, P., RIESGO, M. & GROUP, C.I.S. 2003. Ventilator-associated pneumonia after heart surgery: A prospective analysis and the value of surveillance*. Critical care medicine, 31, 1964-1970.
BOUZA, E., PEREZ, M.J., MUNOZ, P., RINC "N, C., BARRIO, J.M. & HORTAL, J. 2008. Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. CHEST Journal, 134, 938-946.
DEZFULIAN, C., SHOJANIA, K., COLLARD, H.R., KIM, H.M., MATTHAY, M.A. & SAINT, S. 2005. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. The American journal of medicine, 118, 11-18.
DODEK, P., KEENAN, S., COOK, D., HEYLAND, D., JACKA, M., HAND, L., MUSCEDERE, J., FOSTER, D., MEHTA, N. & HALL, R. 2004. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Annals of Internal Medicine, 141, 305-313.
Ventilator associated pneumonia (VAP) accounts for the majority of nosocomial pneumonia which may lead to more extensive hospital stay and increased intensive care. Endrotachael tubes that provide continuous subglotic suctioning (abbreviated: C-ETT) may reduce VAP, but they are more expensive than the standard endrotacheal tubes (abbreviated: -ETT) that do not have the characteristic of continuous suctioning. The objective of this study (peronni et al., 2011), therefore, was to measure the comparative costs of C-ETT against -ETT among intubated people and see whether indeed the more costly C_ETT do show a difference that makes their expense worthwhile.
The issue that was discussed were the comparative merits of C-ETT compared with -ETT and to assess whether the merits of one are more significant than the merits of another and significant to the point that their added cost is worth the hospital's investment in the resource.
2/2: Correct critique of sampling design. Cite guideline…...
mlaSperonni, KG., Lucas, J. & Dugan, L (2011)Comparative Effectiveness of Standard Endotracheal Tubes vs. Endotracheal Tubes With Continuous Subglottic Suctioning On Ventilator-Associated Pneumonia Rates Nursing Economics, 29
Stillwell, S. et al. 92010). Evidence-Based Practice, Step-by-Step: Searching for the Evidence American Journal of Nursing, 10 (5), 41-47
Tuckett, A.G. (2004). Qualitative research sampling: The very real complexities. Nurse Researcher, 12(1), 47 -- 61.
A 65-year-old female with pneumonia
CHIEF COMPLAINT: A 3-day long fever accompanied by a persistent cough
HISTORY: The patient's name is Mrs. Alcot, a sixty-five-year-old woman with a complaint of persistent fever and cough. The patient stated that the illness started three days ago after waking up. A feverish feeling and the ejection of yellowish-green phlegm from the mouth during coughing fits were the symptoms reported at the onset of illness. The symptoms of the illness have since worsened as time passed. A notification was also given a recurring pain in the right chest whenever a deep breath is taken. The patient's husband was reported by the patient to have been ill with similar but milder symptoms a week ago.
PHYSICAL EXAMINATION:
Vital Signs: BP 128/86, HR 101 (regular), RR 18, T 37.4°C
GEN: Slight increase in breathing speed; no discomfort is expressed
Working Diagnosis:
Community-acquired pneumonia (CAP)
Tobacco use disorder
Pathophysiology:
Community-acquired pneumonia (CAP) is considered to be the…...
mlaReferences
Kaysin, A., & Viera, A. J. (2016). Community-acquired pneumonia in adults: diagnosis and management. American Family Physician, 94(9), 698-706.Llinares, P., Menéndez, R., Mujal, A., Navas, E., & Barberán, J. (2014). Guidelines for the management of community-acquired pneumonia in the elderly patient. Rev Esp Quimioter, 27(1), 69-86.Cacciatore, F., Gaudiosi, C., Mazzella, F., Scognamiglio, A., Mattucci, I., Carone, M., ... & Abete, P. (2017). Pneumonia and hospitalizations in the elderly. Geriatric Care, 3(1).Eekholm, S., Ahlström, G., Kristensson, J., & Lindhardt, T. (2020). Gaps between current clinical practice and evidence-based guidelines for treating older patients with Community-Acquired Pneumonia: a descriptive cross-sectional study. BMC infectious diseases, 20(1), 73.Thanavaro J. L. (n.d) Chapter 3: Common respiratory diseases disorders in primary care. Joanes & bartlett Learning, LLC.
Chlorhexidine Gluconate Use in Ventilator Assisted Patients Prevent Ventilator Associated Pneumonia
Chlorahexidine Gluconate
Ventilator associated pneumonia is a common and fatal complicated issue for patients in ventilator care within the intensive care unit. Ventilated and incubated patients are a challenging threat for registered nurses to deliver high quality of care. It has been observed that incubation impedes the natural defense of the body against respiratory infections. The placement of an endotracheal tube enforces negative effect on the cough reflexes, which aims to protect the airway from invasive pathogens. The endotracheal tube prevents mucocoliary clearance of secretions and depresses epiglottic reflexes (ello, Lode, Cornaglia, & Masterton, 2010; Labeau, Vyver, Brusselaers, Vogelaers, & Blot, 2009). It causes the virulent bacteria to enter and it leaks around the inflated cuff of the endotracheal tube. Consequently, the lungs of patient infiltrate due to which pneumonia is caused. The ventilator associated pneumonia possibly occurs early or…...
mlaReference
Abad, C., McKinley, L., & Safdar, N. (2008). Measures to Prevent Ventilator-Associated Pneumonia: Which Are Efficacious? Clinical Review, 71-85.
Chan, E., Ruest, A., Meade, M., & Cook, D. (2007). Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ, 889-899.
Chastre, J., & Fagon, J.Y. (2002). Ventilator-associated pneumonia. Am J. Respir Crit Care Med, 867-903.
Elward, A.M., Warren, D.K., & Fraser, V.J. (2002). Ventilator-associated pneumonia in pediatric intensive care unit patients: risk factors and outcomes. Pediatrics, 758-764.
PICOT
In critically ill adults (p), how does the daily use of chlorohexidine (I) compared to sterile water reduce VAP (ventilator-associated pneumonia) (O) during hospitalized stay (T).
Part 2 Identifying a Problem
Of the infections acquired by patients who've used mechanical ventilation in hospitals, ventilator-associated pneumonia is the most common. It causes several deaths, prolongs hospital stay and adds to the cost of medical care. Ventilator-associated pneumonia is commonly developed when pathogenic bacteria colonize the aero digestive tract. Given this reality, prevention of the infection has always involved preventing bacteria colonization and the following aspiration of the contaminated secretions to the lower airways. (Babcock et al., 2004).
It is necessary that a reappraisal be carried out because of the limitations that the evidence base has. First, the current meta analyses are influenced heavily by three significant studies in patients undergoing cardiac surgery and they accounted for between forty to sixty percent of the patients…...
mlaReferences
Klompas, M., Speck, K., Howell, M. D., Greene, L. R., & Berenholtz, S. M. (2014). Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA internal medicine, 174(5), 751-761.
Zhang, T., Tang, S., & Fu, L. (2014). The effectiveness of different concentrations of chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Journal Of Clinical Nursing, 23(11/12), 1461-1475. doi:10.1111/jocn.12312
Tablan OC, Anderson LJ, Besser R, Bridges C & Hajjeh R (2004) Guidelines for preventing healthcare-associated pneumonia, 2003. Morbidity and Mortality Weekly Report 53, 1-36.
Pruitt, B., & Jacobs, M. (2006). BEST-PRACTICE INTERVENTIONS: How can you prevent Ventilator-Associated Pneumonia? (Cover story). Nursing, 36(2), 36-42.
Pneumonia, as Calkins and Palamountain (2017) point out in their article, Fighting Childhood Pneumonia in Uganda, remains one of the leading causes of death for children under the age of five across the world. As a matter of fact, more children have died from pneumonia related complications in recent times than from measles, malaria and HIV combined. This, in essence, is an indication to the seriousness of the issue – particularly in developing countries. In Uganda, for instance, “approximately 20,000 children under five died from the illness” in 2012; with the said figure being representative of “15 percent of under-five deaths in Uganda” (Calkins and Palamountain, 2017, p. 10). Various initiatives have been undertaken by both the government and INGOs in an attempt to arrest the situation. However, no single approach has yielded significant benefits. Therefore, taking the context of this discussion into consideration, the all-important question remains: what would…...
mlaReferences
Calkins, T, & Palamountain, K. (2017). Fighting Childhood Pneumonia in Uganda. Retrieved from Nkrumah, Y. & Mensah, J. (Eds.). (2014). Accelerating Health Reforms through Collective Action: Experiences from East Africa. Washington, DC: World Bank Publications.United Nations Human Rights (2017). Human Rights Council Holds Panel Discussion on Access to Medicines. Retrieved from http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=21325&LangID=Ehttps://services.hbsp.harvard.edu/services/proxy/content/72006155/72006157/5014d36c8a70f53dec5cb0411a30b81d
suffered from its quasi-experimental approach, as several participants left the study since they left the facility or otherwise were not permitted to participate -- for example, those patients who recovered sufficiently to conduct their own oral care no longer engaged in the experimental protocol and condition. The results were positive and significant, however, the severity of the patients' conditions and the small sample size challenged the researchers, as discussed below.
The title of the article, Oral Intensity: educing Non-Ventilator-Associated Hospital-Acquired Pneumonia In Care-Dependent, Neurologically Impaired Patients, is absolutely clear, unambiguous, and accurate. The abstract offers a clear overview of the study, particularly as it is divided into sections that enable readers to quickly learn about the methodology, results, discussion, and implications of the study. The purpose of the research study is clearly defined: The purpose of the study is to determine if an enhanced oral care protocol would decrease the…...
mlaReferences
Robertson, T. & Carter, D. (2013). Oral intensity: Reducing non-ventilator-associated hospital-acquired pneumonia in care-dependent, neurologically impaired patients. Canadian Journal of Neuroscience Nursing, 35(2), 10-17.
Ryan, F., Coughlan, M. & Cronin, P. (2007). Critiquing Nursing Research. Guidelines for Critiquing a Quantitative Research Study. (also Nieswiedomy, page 297).
[Type text]
To begin writing an essay about upper respiratory tract infections, you want to think about the approach you want to take. Do you want to describe upper respiratory tract infections, discuss causes of these infections, focus on symptoms, or look at different treatment methods? Perhaps you want to do a combination of those things and write a comprehensive essay on the topic. Next, you want to consider your audience. Are you writing a generic essay for a lower-level course in a non-scientific discipline or is your essay for an audience that is....
Outline: Infectious and Lifestyle Diseases
I. Introduction
- Hook: Start with a captivating statistic or narrative that highlights the global burden of infectious and lifestyle diseases.
- Thesis statement: State the central argument that infectious and lifestyle diseases pose significant risks to human health, and that these risks are influenced by various lifestyle factors.
II. Infectious Diseases
- Definition of infectious diseases and their modes of transmission.
- Examples of common infectious diseases (e.g., influenza, pneumonia, tuberculosis) and their associated symptoms and severity.
- Factors contributing to the spread of infectious diseases, including poverty, poor sanitation, and lack of access to healthcare.
- The role of public health....
The Profound Significance of Handwashing: A Cornerstone of Personal Hygiene and Public Health
Handwashing, an indispensable component of personal hygiene, holds profound implications for both individual well-being and public health. The simple act of cleansing hands with soap and water serves as a potent defense against a myriad of harmful microorganisms, thereby preventing the spread of infections and safeguarding the health of communities worldwide.
Handwashing: A Barrier against Microbial Invasion
Pathogenic microorganisms, including bacteria, viruses, and fungi, lurk on surfaces we touch and in the air we breathe. These microscopic adversaries can enter our bodies through various portals, such as the mouth,....
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