Preventing Ventilator-Associated Pneumonia remains a challenge to nurses as they try to promote preventive care to the clients. Considering the mortality and morbidity rates by ventilator-associated pneumonia, it is prudent that the healthcare providers focus on preventive strategies. Lambert et al. (2013) observe that about 7% of the clients receiving nursing care in critical care units suffer from ventilator-associated pneumonia. This author acknowledges that the condition is preventable. Thus, the morbidity burden ought to be reduced by all means possible. Evidence-based research and practice are very pivotal in identifying the most suitable preventive strategies for ventilator-associated pneumonia. The current research paper aims at investigating the effectiveness of use of specially designed endotracheal tubes for removing secretions, as a measure of preventing VAP, as compared to closed, in-line suctioning, in mechanically ventilated patients.

The Institute for Clinical Systems Improvement (ICSI, 2011) documents that the use of specially designed endotracheal tubes has been found to reduce the incidence early development of VAP greatly. Through a meta-analysis, the ICSI (2011) shows that the specially designed endotracheal tube reduces the incidence of early onset of VAP by continuously clearing out secretions from the patient’s sub-glottic area. Closed, in-line suctioning has also been found to reduce the incidence of VAP in mechanically ventilated patients. The two systems target clearing secretions from the patient’s lower airway. In order to encourage the wide application of these strategies, there is a need to determine their effectiveness. The current paper thus aims at determining the effectiveness of use of specially designed endotracheal tubes for removing secretions over closed, in-line suctioning. The PICOT research question for the paper is as follows:

PICOT Research Question:

In mechanically ventilated patients (P), what is the effectiveness of using specially designed endotracheal tubes (I) as compared to closed, in-line suctioning (C) as a method of preventing ventilator-associated pneumonia (O) during the length of hospital stay (T)?

Analysis of PICOT Question:

P-Population- mechanically ventilated patients

I-Intervention- using specially designed endotracheal tubes

C-Comparison of Intervention- Closed, in-line suctioning

O-Outcome- prevention of ventilator-associated pneumonia

T-Time for intervention to achieve the outcome- the length of hospital stay in mechanical ventilation.

References

Institute for Clinical Systems Improvement (ICSI). (2011). Prevention of ventilator-associated pneumonia: healthcare protocol. Bloomington, MN: Author.

Lambert, M., Palomer, M., Agodi, A., Hiesmayr, M., Lepape, A., Ingenbleek, A. … & Frank, U. (2013). Prevention of ventilator-associated pneumonia in intensive care units: an international online survey. Antimicrobial Resistance and Infection Control, 2(9).