390 W Paper Part 1

Hospital Acquired Pneumonia and Oral CareFelicia MonarrezNorthern Arizona UniversityAbstract Hospital Acquired Pneumonia and Oral CarePneumonia is an infection of the lungs that causes inflammation of the air sacs, which may fill with fluid, typically caused by a bacteria or virus. Hospital acquired pneumonia (HAP) is the same infection of the lungs, however it is more commonly caused by a bacterium and is acquired by patients 48 hours or more after being admitted to the hospital and was not existing on admission. HAP is a major safety issue among patients as it the second most common hospital acquired infection (HAI), totaling to 25% of all HAI’s in the U.S. every year (Munro & Baker, 2018). Much focus is placed on ventilator associated pneumonia (VAP) with designated prevention policies from the National Safety Healthcare Network that require monitoring and interventions, however VAP makes up about 38% of HAP, placing about 3.5 million patients at risk every year (Baker & Quinn, 2018). Meanwhile, nonventilator HAP (NV-HAP) accounts for the larger 60% of cases and does not require the same monitoring or interventions to prevent, placing approximately 35 million patients every year exposed to this infection (Quinn & Baker, 2015). Though the mortality rate between NV-HAP and VAP is very similar at just above 18%, NV-HAP impacts more people, thus the overall expenses are nearly doubled and amount to about $40,000.00 more each patient (Baker & Quinn, 2018). NV-HAP, as with nearly all hospital acquired infections, is more common in high-risk patients, such as those with serious hidden diseases, young children or older adults (65 years +), but it can and does happen on every kind of hospital unit. There are no specifications from regulatory agencies to record HAP in connection with patients who are not ventilated and there is not enough encouragement to make unsatisfactory oral care better, which is an alterable component to reduce the risk of this infection. Oral care is imperative, as in a matter of 4-6 short hours nearly 20 billion bacteria duplicate and patients can microaspirate, therefore decreasing this oral bacterium is vital to prevent NV-HAP (Quinn & Baker, 2015) Avoiding pneumonia in hospitals poses many trials. The main trial is a result of the lack of obligation of hospitals to record the amount of cases of pneumonia. Due to this, NV-HAP continues to be an undisclosed illness in hospitals. As Baker and Quinn (2018) analyzed, NV-HAP is underexamined, is a growing concern with more cases than NV-HAP, and preventative measures are often not implemented in acute care hospitals.Research QuestionIn hospitalized, non-ventilated adult patients will using extensive oral care procedures and training reduce the incidence of hospital acquired pneumonia compared to routine oral care during the period of hospitalization within 6 months?Importance to Nursing Nurses have vital roles in the care of patients; such as patient education, incorporating previous experiences, applying evidence-based practices and preventing any hospital acquired infections. Nurses are also advocating for their patients, with the ability to enhance the requirements for patient care. Every patient wants a safe environment and to leave the hospital free of any additional illnesses after hospital admission. As previously mentioned, the bacteria in the oral cavity rapidly multiplies, and it is noted that in 73% of NV-HAP cases, oral care was not logged 24 hours prior to the diagnosis (Quinn & Baker, 2015). The nurse, as provided with the proper education and tools can provide proper oral care or teach and encourage oral care by the patient to help reduce the prevalence of NV-HAP. ReferencesBaker, D., & Quinn, B. (2018). Hospital Acquired Pneumonia Prevention Initiative-2: Incidence of nonventilator hospital-acquired pneumonia in the United States. American Journal of Infection Control, 46(1), 2–7. https://doi.org/10.1016/j.ajic.2017.08.036 (primary)El-Rabbany, M., Zaghlol, N., Bhandari, M., & Azarpazhooh, A. (2015). Prophylactic oral health procedures to prevent hospital-acquired and ventilator-associated pneumonia: A systematic review. International Journal of Nursing Studies, 52(1), 452-464. doi:10.1016/j.ijnurstu.2014.07.010 (secondary)Munro, S., & Baker, D. (2018). Reducing missed oral care opportunities to prevent non-ventilator associated hospital acquired pneumonia at the Department of Veterans Affairs. Applied Nursing Research, 44, 48-53. doi:10.1016/j.apnr.2018.09.004 (primary)Quinn, B., & Baker, D. L. (2015). Comprehensive oral care helps prevent hospital-acquired nonventilator pneumonia: a nurse-led prevention initiative proved that oral care is far more than just a comfort measure. American Nurse Today, 10(3), 18+. Retrieved from http://link.galegroup.com.ezlib.gatewaycc.edu:2048/apps/doc/A411615948/AONE?u=mcc_gateway&sid=AONE&xid=d5c77416 (primary)

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