Ventilator Associated Pneumonia In Adult:Its Prevention,and The Nurses' Role

Ventilator associated pneumonia(VAP) is one of the most frequent nosocomial infections among ventilated patients in Intensive Care Units(ICUs),associated with an increase in days of ICU stay,morbidity and mortality.Prevention of VAP is much more cost-effective than treatment and is a major concern in every hospital.Nurses have an important role in preventing VAP,as most of the interventions and prevention strategies are part of routine nursing care.This Systematic review aimed to approach the most consensual preventive measures of VAP.The data sources used were PubMed,CINAHL,EMBASE,Cochrane,VIP,CNKI,and WANGFANG DATA.Searches of this database were restricted to publications from January 2008 to Jan 2019.All Case-control studies among adult intubated patients in ICUs using the VAP bundle for the treatment were included.Studies study other than the adult like study only of the neonate and Pediatrics were excluded.In adult also,if the study of any specific population or any specific disease condition,those were excluded.Lack of knowledge of proper nursing care of ventilated patient among nurses may become a barrier in adhering to evidence-based guidelines for preventing VAP.It is important to understand the pathophysiology of VAP,its risk factors and care bundle for the proper prevention and treatment of VAP.Nurses have a multidimensional role as a care provider,educator,patient advocator,manager,collaborator,leader,and researcher in the prevention of VAP.There must be specific protocols,strategies and active surveillance in every ICU regarding the care bundle.Routine oral care,appropriate handwashing,use of protective barriers when handling ventilated patients,controlling the bacterial colonization in oropharynx and stomach,endotracheal(ET) suctioning,maintenance of cuff pressures and elevating the head of bed helps are the important nursing interventions for the VAP prevention.In every ICU,proper tools and resources should be provided to the nurses sufficiently in order to implement appropriately and timely interventions.The importance should be given on the surveillance,prevention,education,timely interventions of the care bundles and a team effort for the better result.The nurses are still facing several challenges in accomplishing these goals.