EBP project presentation

EBP Project Presentation
Name
Institution Affiliation

PICO Question
How has the ventilator-associated pneumonia level decreased by a higher nurse-patient ratio and what is the impact of a low nurse to patient ratio on the VAP incident intervention in the ICU?
Discussion
The Intensive Care Unit adults’ patients that are suffering from ventilator-associated pneumonia have been on the rise. And also the impact of the VAP on these has been worsening in the healthcare. This problem has been brought about by the limited numbers of nurses that are attending to these patients in the ICU. For instance, the nurse to the patient has been very low, i.e., 1:6. This means that one nurse has been taking care of six patients at ago. As a result of this problem, it has been discovered that increased nurse staffing has a great positive impact on the patient care. For example, if the nurse to patients’ ratio is reduced to a manageable size, then it would be easy to take care of the patients suffering from VAP in the ICU. The manageable ratio would be 1:2, one nurse taking care of two patients in the ICU concurrently.
The main aim of the study was to determine the effect of increasing the nurse staffing in the healthcare to take care of the ICU adults suffering from ventilator-associated pneumonia. For instance, having a high/optimal Nurse-patient ratio of 1:2. On the same note, it would involve the investigation on the side effect of the low nurse-patient ratio of 1:6 in the healthcare. In order to accomplish these research objectives, several methods were used as follows; Through training of the nurses; Reviewing the VAP episodes; Conducting research from various articles; Investigating the nurses’ activities in the ICU; Making an observation on how the nurses provide the guideline of preventing VAP among the patients.

The first article that was used concerning the nurses’ implementation of ventilator‐associated pneumonia prevention guideline, it was discovered that the 63% of the nurses used in the research portrayed insufficient compliance (Aloush, 2017). This was an indication that most of the nurses lack a proper understanding of the guidelines that are required to be used in the prevention of the VAP. On the other hand, when nurse staffing, burnout, and healthcare-associated infection was conducted in another healthcare, the results got were as follows; Nurse burnout was significantly related to urinary tract infection (0.82; P = .03) while surgical site infection results in (1.56; P < .01) (Cimiotti, Aiken, Sloane & Wu, 2012). And also the reduction of the burnout in hospitals results in reduced infection by 30%. According to Driscoll and colleagues, it was found that increased “staffing was associated with limited medical errors caused as well as low mortality rate” (Driscoll et al., 2017). Just still on the staffing level, another research performed indicated that late-onset VAP related to was 61% of the total episodes (Hugonnet, Uçkay & Pittet, 2007). Additionally, high nurse-to-patient ratio resulted to a decreased risk experienced for late-onset VAP; however, there was no relationship found for the early onset of VAP. Finally, it was realized that when nurses are trained, they display competency in the health activities they were performing as compared to before training (Ismail & Zahran, 2015).
Therefore the articles that have been used in the research were related to the nurse-patient ratio and how it intervenes to the caretaking of the patients suffering from VAP in the ICU. Therefore, it is recommended that the number of nurses is increased in every hospital to enhance quality care in the ICU.
References
Aloush, S. (2017). Nurses’ implementation of ventilator-associated pneumonia prevention guidelines: an observational study in Jordan. Nursing In Critical Care, 23(3), 147-151. doi: 10.1111/nicc.12323
Cimiotti, J., Aiken, L., Sloane, D., & Wu, E. (2012). Nurse staffing, burnout, and health care-associated infection. American Journal Of Infection Control, 40(6), 486-490. doi: 10.1016/j.ajic.2012.02.029
Driscoll, A., Grant, M., Carroll, D., Dalton, S., Deaton, C., & Jones, I. et al. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal Of Cardiovascular Nursing, 17(1), 6-22. doi: 10.1177/1474515117721561
Hugonnet, S., Uçkay, I., & Pittet, D. (2007). Staffing level: a determinant of late-onset ventilator-associated pneumonia. Critical Care, 11(4), R80. doi: 10.1186/cc5974
Ismail, R., & Zahran, E. (2015). The effect of nurses training on ventilator-associated pneumonia (VAP) prevention bundle on VAP incidence rate at a critical care unit. Journal Of Nursing Education And Practice, 5(12). doi: 10.5430/jnep.v5n12p42