discussion question on EBP

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Lbunaa

Humanities

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For this small group discussion, discuss the following:

First post due by Wednesday @ 11:59PM. In first post, each student must address ALL components of the discussion board (i.e., all 4 questions) in order to be eligible for full discussion points. Please follow Discussion Rubric. Discussion board closes on Sunday @ 11:59PM.

1. Identify and describe a clinical issue you are interested in addressing. How is this a researchable clinical issue?

2. Conduct a search for a quantitative article relevant to the clinical issue you are interested in addressing. Describe the search strategy used, including which database(s) and key search terms you used.

3. Attach the article you have selected.

4. Identify and discuss the theoretical framework used by the researchers/authors. What significance does this theoretical framework have to the research design presented in the article?

Additional note on my part it could be anything related to health care issue that will be my preference if not whatever issue you chose will also be ok with me.I was thinking about ventilator acquired pneumonia. Let me know if u have time thank you. Its worth max 10 points

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Explanation & Answer

Hi,Find attached the completed work.Feel free to ask for any clarification or editing if need be.Looking forward to working with you in the future.Thank you.

Dominican University of California

Dominican Scholar
Senior Theses and Capstone Projects

Theses and Capstone Projects

12-2015

An Exploration of Nurse Adherence to VentilatorAssociated Pneumonia Bundle Interventions: A
Quantitative Study
Alexis Luna
Dominican University of California

Follow this and additional works at: http://scholar.dominican.edu/senior-theses
Part of the Critical Care Nursing Commons, and the Other Analytical, Diagnostic and
Therapeutic Techniques and Equipment Commons
Recommended Citation
Luna, Alexis, "An Exploration of Nurse Adherence to Ventilator-Associated Pneumonia Bundle Interventions: A Quantitative Study"
(2015). Senior Theses and Capstone Projects. Paper 43.

This Honor's Thesis is brought to you for free and open access by the Theses and Capstone Projects at Dominican Scholar. It has been accepted for
inclusion in Senior Theses and Capstone Projects by an authorized administrator of Dominican Scholar. For more information, please contact
michael.pujals@dominican.edu.

NURSE FACTORS & VAP BUNDLE ADHERENCE

1

An Exploration of Nurse Adherence to Ventilator-Associated Pneumonia Bundle Interventions:
A Quantitative Study

By Alexis A. Luna
Dominican University of California
Dr. Oliva Catolico
Dr. Patricia Harris
NURS 4993.H
December 6, 2015

NURSE FACTORS & VAP BUNDLE ADHERENCE

COPYRIGHT © 2015 ALEXIS A. LUNA. ALL RIGHTS RESERVED.

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NURSE FACTORS & VAP BUNDLE ADHERENCE

Acknowledgements
I would like to express my immense gratitude to my thesis advisor, Dr. Olivia Catolico,
for her continued support, encouragement, and guidance throughout the duration of this project.
The amount of time and energy she has dedicated to mentoring me this past year has been
incredible, and she has shown herself as a truly amazing woman.
In addition to my thesis advisor, I want to recognize and extend my gratitude to my
second reader, Dr. Patricia Harris, whose efforts have allowed me to provide critical statistical
analyses of my data. Even more so, her passion for nursing research inspired me to continue
working diligently and thoroughly towards the end of the project.
Lastly, the collected data of my project would not have been as interesting or as
numerous without the assistance of my industrious mother, Jane Luna RN. She went above and
beyond my expectations of her role and has wholly allowed my thesis to come to fruition.

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NURSE FACTORS & VAP BUNDLE ADHERENCE

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Table of Contents
Acknowledgements .....................................................................................................................3
Abstract ......................................................................................................................................5
Introduction ................................................................................................................................6
Background of the VAP Bundle ..................................................................................................7
Purpose Statement .......................................................................................................................8
Literature Review ........................................................................................................................8
Theoretical Framework ............................................................................................................. 14
Research Design........................................................................................................................ 15
Methodology ............................................................................................................................. 17
Sample Population ................................................................................................................. 18
Instrument ............................................................................................................................. 19
Ethical Considerations ........................................................................................................... 21
Data Collection Procedures.................................................................................................... 21
Data Management .................................................................................................................. 22
Results ...................................................................................................................................... 23
Section 1: Nurse Factors ........................................................................................................ 23
Section 2: Nurse Understanding and Perceptions of VAP and VAP bundle ............................ 26
Section 3: VAP Bundle Implementation According to Hospital Policy/Guidelines ................. 26
Statistical Analysis .................................................................................................................... 29
Discussion................................................................................................................................. 32
Research Study Limitations ....................................................................................................... 35
Implications for Nursing Practice .............................................................................................. 35
References ................................................................................................................................ 37
Appendix A............................................................................................................................... 39
Appendix B ............................................................................................................................... 40
Appendix C ............................................................................................................................... 50
Appendix D............................................................................................................................... 51
Appendix E ............................................................................................................................... 55
Appendix F ............................................................................................................................... 56

NURSE FACTORS & VAP BUNDLE ADHERENCE

5

Abstract
Ventilator-associated pneumonia (VAP) poses a significant health risk to patients on mechanical
ventilation in hospital intensive care units (ICU). It is the responsibility of the nurse to
implement VAP bundle interventions to decrease the prevalence of VAP in mechanically
ventilated patients. The objective of the study was to measure nurse perception of adherence to
VAP bundle interventions of oral hygiene, head-of-bed elevation, spontaneous breathing trials,
daily sedation vacations, and peptic ulcer and deep vein thrombosis prophylaxis. A descriptive
study involving a sample population of 28 ICU nurses at 3 hospitals in northern California was
conducted. A 57-item questionnaire was developed to gather data on the degree to which VAP
bundle interventions were implemented by the ICU nurses. All but one nurse reported
implementing VAP bundle interventions in accordance with hospital policy. Self-reported nurse
perception of adherence to VAP bundle interventions was considered met for 68% of the sample
population. Self-reported adherence to VAP bundle interventions indicated nurses were
appropriately implementing them in accordance with hospital policy/guidelines. More critical
examination of VAP bundle hospital protocol is needed in order to identify areas for
improvements in nursing practice.
Keywords: nurse adherence, ventilator-associated pneumonia, VAP, VAP bundle, nurse
compliance

NURSE FACTORS & VAP BUNDLE ADHERENCE

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An Exploration of Nurse Adherence to Ventilator-Associated Pneumonia Bundle
Interventions: A Quantitative Study
Ventilator-associated pneumonia (VAP) is defined as pneumonia occurring 48 hours after
the patient was intubated and put on mechanical ventilation. Mechanical ventilation is an
intervention that assists patients in breathing by giving oxygen through a tube placed in the
mouth, nose, or tracheostomy. Because the tube enters the trachea, microorganisms can invade
the lower respiratory track and increase the risk for VAP. Though common signs and symptoms
include progressive infiltrate on chest radiograph, leukocytosis, purulent tracheobronchial
secretions, and gas exchange degradation, poorly defined clinical criteria makes VAP difficult to
diagnose and treat appropriately. The Center for Disease Control algorithm helps to clarify the
clinical criteria and aims to assist in correctly diagnosing VAP (Munro & Ruggiero, 2014).
Ventilator-associated pneumonia is a significant contributor to patient morbidity and
mortality in Intensive Care Units (ICU) and makes up 86% percent of nosocomial pneumonias
(Koenig & Truwit, 2006, p.637). VAP is associated with an estimated mortality rate between
20% and 70% and increased lengths of stay in ICU by 4-13 days for mechanically ventilated
patients (Cason, Tyner, Saunders, & Broome, 2007; Koenig & Truwit, 2014). Increased lengths
of stay and additional treatments that occur as a result of VAP contribute to high hospital costs.
Despite its insidious onset, research has demonstrated that treatment within the first 48 hours can
significantly reduce mortality by at least 30% (Koenig & Truwit, 2006, p.637). Preventative
measures such as the VAP bundle can be taken to reduce the incidence of VAP during
hospitalization. In doing so, the health and wellness of patients who are already in critical
condition can be protected and improved...


Anonymous
Just what I was looking for! Super helpful.

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