Research Articles Base: Nursing

THE IMPACT OF BACKREST ELEVATION ON THE DEVELOPMENT OF VENTILATOR ASSOCIATED PNEUMONIA

THE IMPACT OF BACKREST ELEVATION ON THE DEVELOPMENT OF VENTILATOR ASSOCIATED PNEUMONIA         According to the US American Journal of Critical Care Pneumonia is due to noscomial infection and another leading cause of death in the United States and other countries. The inflammation of one or both lungs due to this virus irritates the respiratory tract that promotes bacterial spread and may induce mucus secretion release constantly in our body. Medical experts have found a need to experiment for the cure of such infectious and deadly disease that is why the development of backrest elevation of the Ventilator Associated Pneumonia has been introduced. The person who suffered this critical level of the disease may require the use of mechanical ventilation or a breathing machine within 48 hours because they may suffer breathing seriously and may cause death if not been treated in time. The death rate of this disease of Ventilator Associated Pneumonia is critically high and it required immediate treatment upon diagnosis.       The Center for Disease Control and Prevention have recommended the use of Backrest Elevation to a 30 degree during the first 24 hours to 45 degree during the next few hours to this angle so that the Ventilator Associated Pneumonia could reduce the risk  or be slightly prevented. Ventilator Associated Pneumonia may still be developed in people of serious condition if the backrest elevation is less than 30 degree during the first few hours and the development of VAP may still arise during 24 hours. Therefore positioning the patient is the key component of nursing aide to protect them. The elevation of the head gradually reducing the patient must have been the key where there is no medical contradiction this has been the chosen position.       From this point of view there are still negative implication of the position on the part of the patient since the complication of the 30 degree to 45 degree may affect the risk pressure and may form ulcer formation due to prolong position and that patient may slide down from the machine eventually due to their body weights especially from the elderly and bed ridden patients. To prevent this from happening there should be a continual monitoring of backrest elevation educating the nurse and immediate family and patient to maintain their position.       Study shows that it is a misconception that the critically ill patient should lay down on a supine position (lying on the back with face upward position) this position may create a major impact on the condition of the patient to highlight the risk of backrest and basically complication may occur. These findings have largely contributed to the Development of Backrest Elevation of Ventilator Associated Pneumonia.       In a recent study conducted in the medical respiratory in Virginia Commonwealth University Health System Intensive Care Unit (ICU). This room can accommodate at least 1000 patient each year because of its large capacity of 12 beds where half of them may require mechanical ventilation where included in the study excluding the patients using the intubation (inserting a tube through the vocal chords into the windpipe to provide oxygen into the lungs) where intubation would increase the risk of VAP, this reduce the patients to 276 to be studied that is sufficient enough that will indicate the efficiency of backrest elevation in the development of Ventilator Associated Pneumonia. Data development record has been critically measured in a comprehensive and accurate manner during admission of patient until a week of study. They have also developed a transducer measuring system to measure the elevation consequently for accurate recording over time and continuous data recording has been done every 10 minutes. Other data that is related to the VAP risk were also included to support the study. During the day of study period the patient is consistently in backrest elevation position. Initially they have gathered volume of data that results in the creation of formula to simplify the figures and expert has been very happy about the outcome.       The study has been reviewed and approved by the University Board and suggestions have been implemented to obtain the backrest elevation system and this has been the result of the study to prove the impact of backrest elevation. No direct association of backrest elevation and ventilator associated pneumonia was found. And the previous conclusion that Ventilator Associated Pneumonia was more likely to develop in patient suffering from serious ailment that spend more time at backrest elevation of less than 30 degree during the first day of intubation.  (American Journal of Critical Care 2005)                   Credit:ivythesis.typepad.com

THE IMPACT OF BACKREST ELEVATION ON THE DEVELOPMENT OF VENTILATOR ASSOCIATED PNEUMONIA

THE IMPACT OF BACKREST ELEVATION ON THE DEVELOPMENT OF VENTILATOR ASSOCIATED PNEUMONIA According to the US American Journal of C...

Exploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease

Exploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease Nurses are in a unique position to diagnose and treat human responses to actual or potential health problems. The nurse practitioner can have a positive impact on the prevention and management of cardiovascular disease through patient education and counseling.  Nurse Practitioners are oftentimes the first healthcare provider seen when there is a new patient.  The Nurse Practitioner conducts the initial evaluation and sets up the care plan which includes primary and secondary prevention strategies. The success of your patient teaching plan is measured through the patient’s compliance to the prescribed treatment plan.  Your teaching should be set up with goals that will enhance compliance. You need to make the assessment with the patient and family to focus on maximum compliance. Each visit should incorporate a review of the goals that were set and examples of how the patient is meeting or not meeting those goals. When you are following up during your visit to assess the success, if the patient has not followed the plan ask for the patient’s help to identify what is preventing him from being successful and revise the plan based on revised goals (Solomon, 2000). If the patient has even had small successes it is important to congratulate them and focus on those positives as you reformulate goals.  Provide the patient with resources to help support his plan. Remember that there are many references out there in the internet. Some are not so accurate, that may have just the opposite effect you and the patient are trying to achieve. By providing the patient with a take home list of resources you can be sure the information is the right information for the patient [http://nursesaregreat.com/articles/rrfh.htm].  The ICSI Health Care Guideline was designed to assist clinicians by providing an analytical framework for the evaluation and treatment of patients, and is not intended either to replace a clinician’s judgment or to establish a protocol for all patients with a particular condition.  The guideline outlines the existing evidence for the effectiveness of strategies and programs designed to help adults successfully make essential changes to achieve healthier lifestyles (increased physical activity, improved nutrition, decreased tobacco use and exposure, decreased hazardous and harmful drinking/alcohol use). It also outlines how these programs might be integrated into preventive services in health care systems, which traditionally have focused on early detection of disease or treatment of risk factors rather than preventing the onset of risk factors. Nearly all individuals would derive measurable benefits from healthier lifestyles; even small improvements across a large portion of the population would have a greater impact than focusing on a small portion of the population that is at the upper end of the risk distribution. Therefore, the target population for this guideline includes all adults (age 18 and older) in the community, irrespective of their utilization of the health care system. Although this guideline focuses on adults, adolescents and children may benefit from many of the components or recommendations in this guideline [http://www.icsi.org/chronic_disease_risk_factors__primary_prevention_of__guideline__23506/chronic_disease_risk_factors__primary_prevention_of__guideline__23508.html]. Nurse practitioners should follow these guidelines to create a successful educational plan for their patients.  They should teach the following four lifestyle behaviors – 1.    adequate physical activity 2.    a diet that emphasizes fruits and vegetables 3.    abstinence from tobacco and avoidance of tobacco smoke 4.    avoidance of hazardous and harmful drinking These are associated with a decade or more of increased life expectancy. Individuals, who adopt this lifestyle, at any age, have significantly lower total mortality rates [http://www.icsi.org/chronic_disease_risk_factors__primary_prevention_of__guideline__23506/chronic_disease_risk_factors__primary_prevention_of__guideline__23508.html]. After you begin your teaching plan it is important for compliance and success to evaluate where you are. This allows you and the patient to reset goals and stay on target. It will ensure greater success (Patient Teaching, 2001). Evaluation of lifestyle changes should be part of each visit to help the patient stay on track. Follow-up visits are planned based on patient needs. For example if you have a patient with elevated blood pressure and you are using lifestyle modification as an initial treatment plan you may want an every two week follow-up. For many patients a more realistic follow up is monthly. Evaluation and revision of the teaching plan is part of every visit [http://nursesaregreat.com/articles/rrfh.htm].   Credit:ivythesis.typepad.com

Exploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease

E xploring the role of the nurse in preventing and controlling risks factors in cardiovascular disease Nurses are in a unique positio...