Preventing Ventilator Associated Pneumonia in ICU: Evidence Based Practice

Running head: EVIDENCE BASED PRACTICE
Evidence based practice
Name of the student:
Name of the University:
Author’s note

1EVIDENCE BASED PRACTICE
Introduction
Ventilator associated pneumonia (VAP) is a common nosocomial infection in the ICU
that is associated with increased morbidity, mortality and medical cost. It is type pneumonia
where symptoms of fever, altered white blood count and sputum changes are seen following 48-
72 hours of endotracheal intubation (Kalanuria, Zai & Mirski, 2014). Hence, the condition is
most likely to be found in mechanically ventilated patients and it increases burden for critical
care nurses. In response to this issue, the main purpose of the paper is to discuss how ventilator
pneumonia as an issue in the ICU and identify the research article that provides the strongest
evidence to prevent the issues. The description of best evidence is provided following the steps
of the EBP process.
Rational for EBP as an issue in ICU practice
VAP is regarded as an undesirable condition in ICU patient because it increases length of
stay in the intensive care unit and prolongs duration of ventilator support. The rate of VAP in
hospital varies due to diagnostic criteria and knowledge of nurses in preventing the condition.
Barriers and facilitator to managing VAP in the ICUs may also vary because of factors like
communication between staffs, education and knowledge related to VAP, guideline awareness,
management process for VAP and appropriate use of technology (Safdar et al., 2016). Another
issue for nurse is that variety of preventive measures has been recommended for preventing VAP
Eom et al. (2014), however the effectiveness of these intervention needs to be confirmed by
means of evidence based practice process.
Preventing VAP through the EBP process:

2EVIDENCE BASED PRACTICE
Evidence based practice (EBP) is regarded as a process that can support nurses to address
gap in patient care and achieve better health outcome for patient. By engaging in the process of
the judicious use of current best evidence related to practice issue and integration of the evidence
with patient values and clinical expertise, optimal care can be provided to patients (Hall &
Roussel, 2016). This paper is concerned with the practice issue of prevention of VAP in ICU.
The six steps of the EBP process that can help to identify the best evidence that supports
prevention of VAP in the ICU are as follows:
1. Asking a clinical guiding question:
The best research articles for prevention of VAP in ICU can be retrieved by ICU nurse by
first developing a clinical guiding question. The PICO question for the use of VAP can be as
follows:
Which preventive measures (intervention) are most useful in the prevention of VAP
(outcome) in ICU patients (population)?
2. Searching for the best evidence
Keywords from the clinical question can be used to search for relevant articles related to the
practice issue. Terms like preventive measures and VAP, VAP prevention and ICU patients and
prevention for VAP can be used to retrieve relevant articles. The articles can be searched from
different databases and search engines like Google Scholar. The search for articles related to the
prevention of VAP revealed implementation of VAP bundle approach as the most effective
approach to prevent VAP as it includes variety of interventions to reduce the incidence of VAP.
The Institute for Healthcare Improvement (IHI) developed the bundle and it includes all
interventions necessary for VAP prevention such as elevation of head of bed (30°- 45°), daily