The Role Of Respiratory Therapists And Nursing In Reducing And Preventing Of Ventilator-Associated Pneumonia
Abstract
Background: Ventilator-associated pneumonia (VAP) comprises ~50% of nosocomial pneumonias and remains the most frequent infection among mechanically ventilated patients, driving mortality, prolonged ICU/hospital length of stay, antimicrobial exposure, and costs. Diagnostic ambiguity, shifting CDC definitions to ventilator-associated events (VAEs), and the SARS-CoV-2 era have complicated surveillance and benchmarking.
Aim: To synthesize practical, evidence-based strategies—especially those enacted by respiratory therapists (RTs) and nursing—to reduce VAP incidence and improve patient-centered outcomes.
Methods: Narrative integration of randomized trials, meta-analyses, and prospective cohorts cited in the source text, emphasizing core bundle elements (head-of-bed elevation, daily sedation interruption, spontaneous breathing trials), early mobilization, oral care/decontamination options, circuit stewardship, subglottic drainage, and implementation science.
Results: Highest-yield measures shorten ventilator exposure and curb aspiration: semirecumbency (30°–45°), light/goal-directed sedation with daily awakening and synchronized SBTs, and early mobilization improve ventilator-free days and functional outcomes. Oral chlorhexidine reduces VAP chiefly in short-stay cardiac cohorts; signals of harm in general ICUs warrant caution. Subglottic drainage lowers early VAP, particularly within comprehensive bundles. Probiotics lack benefit. Compliance, education, and feedback loops determine real-world effectiveness.
Conclusion: RT- and nursing-led, implementation-ready bundles that minimize ventilation days and aspiration—augmented by targeted technologies and antimicrobial stewardship—can meaningfully attenuate VAP while preserving resources.
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References
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Copyright (c) 2024 Jassim Mohammed Al Essa, Zahrah Essa Alabbas, Bibi Ahmad Alhamoud, Zahra Abdullah Ali Alaskari, Fatimah Mohammad Thuaimer, Afnan Ahmad Alnigie, Amirah Hassan Amer Asiri, Dalal Suliman Mohd Asiri, Elham Hussain Sharaf Altaha, Khaled Alnashmi F Alanazi
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